Healthcare Provider Details

I. General information

NPI: 1821607854
Provider Name (Legal Business Name): VALENCIA MICHELLE BOCARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 05/05/2024
Certification Date: 05/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11408 LAKE SHERWOOD AVE N STE A
BATON ROUGE LA
70816-0421
US

IV. Provider business mailing address

PO BOX 2506
OPELOUSAS LA
70571-2506
US

V. Phone/Fax

Practice location:
  • Phone: 225-261-7143
  • Fax:
Mailing address:
  • Phone: 985-351-8469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: