Provider Demographics
NPI:1669529814
Name:VOLLMAN, VALERIE DANEEN (LOTR, CHT)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:DANEEN
Last Name:VOLLMAN
Suffix:
Gender:F
Credentials:LOTR, CHT
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:DANEEN
Other - Last Name:CUSHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LOTR
Mailing Address - Street 1:2600 BELLE CHASSE HWY
Mailing Address - Street 2:SUITE I
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7156
Mailing Address - Country:US
Mailing Address - Phone:504-391-7670
Mailing Address - Fax:
Practice Address - Street 1:2600 BELLE CHASSE HWY
Practice Address - Street 2:SUITE I
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-7156
Practice Address - Country:US
Practice Address - Phone:504-391-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ11630225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5X734CQ94Medicare PIN