MEDICARE: VALERIE FLORETTA HACKNEY

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1992005458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE FLORETTA HACKNEY

Provider Business Mailing Address
First Line	:	866 GREEN RIDGE DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-7355
Country	:	US
Telephone Number	:	804-230-7975
Fax Number	:

Provider Business Practice Location Address
First Line	:	866 GREEN RIDGE DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-7355
Country	:	US
Telephone Number	:	804-230-7975
Fax Number	:

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

Provider Enumeration Date	:	10/29/2010
Last Update Date	:	10/29/2010

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Directions to “ VALERIE FLORETTA HACKNEY ” Practice Location

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