Healthcare Provider Details

I. General information

NPI: 1679920268
Provider Name (Legal Business Name): VALEN GEORGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S COLLEGE RD STE 100
LAFAYETTE LA
70503
US

IV. Provider business mailing address

251 REES ST
BREAUX BRIDGE LA
70517-4611
US

V. Phone/Fax

Practice location:
  • Phone: 337-205-6073
  • Fax:
Mailing address:
  • Phone: 337-442-6823
  • Fax: 337-442-6825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: