MEDICARE: MRS. VALERIE LYNN GUALDONI MA,CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2202334A	IN

General Provider Information

NPI Number	:	1982799912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VALERIE LYNN GUALDONI MA,CCC-SLP

Provider Business Mailing Address
First Line	:	8236 GREENWICH CT
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-8321
Country	:	US
Telephone Number	:	260-485-6083
Fax Number	:	260-373-2335

Provider Business Practice Location Address
First Line	:	3926 NEW VISION DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1712
Country	:	US
Telephone Number	:	260-373-2300
Fax Number	:	260-373-2335

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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