Provider Demographics
NPI:1447320395
Name:RAVENSCROFT, VALERIE MAE (SLP)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:MAE
Last Name:RAVENSCROFT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:VALERIE
Other - Middle Name:MAE
Other - Last Name:CATHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:17138 KNOBLEY RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26710-7478
Mailing Address - Country:US
Mailing Address - Phone:304-216-6528
Mailing Address - Fax:
Practice Address - Street 1:25701 SHADY LN SW
Practice Address - Street 2:
Practice Address - City:WESTERNPORT
Practice Address - State:MD
Practice Address - Zip Code:21562
Practice Address - Country:US
Practice Address - Phone:301-359-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1068235Z00000X
MD05284235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist