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General NPI Number Information
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NPI Number | 1275223117
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Entity Type | Individual
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Provider Name | VALERY MARYELLEN SQUARE
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Gender | Female
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 05/14/2023
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Provider Practice Location Address
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Address Line | 155 CONESTOGA ST
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City | STEELTON
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State | PA
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Zip | 17113-2263
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Country | US
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Telephone | 223-667-4238
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Fax | 717-828-4845
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Provider Business Mailing Address
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Address Line | 155 CONESTOGA ST
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City | STEELTON
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State | PA
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Zip | 17113-2263
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Country | US
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Telephone | 223-667-4238
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Fax | 717-828-4845
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247000000X
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Taxonomy Name | Health Information Technician
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License Number |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 96C08A27C81842EFBB39
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License Number State | PA
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