Provider Demographics
NPI:1679176374
Name:YAKELEWICZ ORTIZ LARROY, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:YAKELEWICZ ORTIZ LARROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 STATE ROUTE 821
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-5302
Mailing Address - Country:US
Mailing Address - Phone:740-336-3983
Mailing Address - Fax:
Practice Address - Street 1:127 STATE ROUTE 821
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-5302
Practice Address - Country:US
Practice Address - Phone:740-336-3983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant