Provider Demographics
NPI:1295982221
Name:GIFFORD, VALERIE (COTA)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 MCCLURG LN
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:KY
Mailing Address - Zip Code:41141-8458
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:398 FINCASTLE RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45697-9783
Practice Address - Country:US
Practice Address - Phone:937-695-0839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKYA3540224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant