Healthcare Provider Details

I. General information

NPI: 1871803841
Provider Name (Legal Business Name): VALERIE NICOLE BOYER MOTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8109 ADDINGTON DR
COMMERCE TOWNSHIP MI
48390-4011
US

IV. Provider business mailing address

8109 ADDINGTON DR
COMMERCE TOWNSHIP MI
48390-4011
US

V. Phone/Fax

Practice location:
  • Phone: 954-551-5340
  • Fax:
Mailing address:
  • Phone: 954-551-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number5201007429
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: