Provider Demographics
NPI:1144529447
Name:DALTON, VALERIE RITA (LPN/ MPH)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:RITA
Last Name:DALTON
Suffix:
Gender:F
Credentials:LPN/ MPH
Other - Prefix:MS
Other - First Name:VALERIE
Other - Middle Name:RITA
Other - Last Name:DALTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN/MPH
Mailing Address - Street 1:176 WINTHROP SHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1208
Mailing Address - Country:US
Mailing Address - Phone:617-207-9048
Mailing Address - Fax:
Practice Address - Street 1:176 WINTHROP SHORE DR
Practice Address - Street 2:176 WINTHROP SHORE DRIVE
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-1208
Practice Address - Country:US
Practice Address - Phone:617-207-9048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YA0400X
MALPN 1023164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)