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General NPI Number Information
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NPI Number | 1730448432
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Entity Type | Individual
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Provider Name | VALERIE J LESSARD COOK LMT, MMP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 97 MAIN ST SUITE W 104
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City | EDWARDS
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State | CO
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Zip | 81632-8126
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Country | US
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Telephone | 970-331-1997
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1757
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City | AVON
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State | CO
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Zip | 81620-1757
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Country | US
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Telephone | 970-331-1997
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 12754
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License Number State | CO
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