Provider Demographics
NPI:1538581822
Name:GRAYSON, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:GRAYSON
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 1:20139 PALM BLVD
Mailing Address - Street 2:20139 PALM BOULEVARD
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-6453
Mailing Address - Country:US
Mailing Address - Phone:985-249-4448
Mailing Address - Fax:
Practice Address - Street 1:20139 PALM BLVD
Practice Address - Street 2:20139 PALM BOULEVARD
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70435-6453
Practice Address - Country:US
Practice Address - Phone:985-249-4448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management