Basic Information
| Provider Information | |||||||||
| NPI: | 1659978286 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALYO | ||||||||
| FirstName: | MAREN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1251 COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | ALTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 620026735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184637330 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1251 COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | ALTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 620026735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184637330 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2020 | ||||||||
| LastUpdateDate: | 10/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 242.006111 | IL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.