Healthcare Provider Details

I. General information

NPI: 1053686659
Provider Name (Legal Business Name): BERNADETTE M. VALERIO PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2012
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US

IV. Provider business mailing address

9300 DEWITT LOOP EAGLE PAVILION, 3RD FLOOR , RM 3.143
FORT BELVOIR VA
22060
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-2198
  • Fax:
Mailing address:
  • Phone: 571-231-2198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305206323
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: