Healthcare Provider Details

I. General information

NPI: 1033013032
Provider Name (Legal Business Name): EMILY VALLEE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5823 WIDEWATERS PKWY STE 3
EAST SYRACUSE NY
13057-3081
US

IV. Provider business mailing address

PO BOX 580
SYRACUSE NY
13214-0580
US

V. Phone/Fax

Practice location:
  • Phone: 315-418-4000
  • Fax:
Mailing address:
  • Phone: 315-251-3410
  • Fax: 315-552-6046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number031468
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: