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General NPI Number Information
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NPI Number | 1578936985
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Entity Type | Individual
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Provider Name | SHANDRIEKA POREE VALLARE
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Gender | Female
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Dates
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Enumeration Date | 11/06/2015
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 2626 CANAL ST
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City | NEW ORLEANS
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State | LA
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Zip | 70119-6400
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Country | US
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Telephone | 504-525-2366
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Fax |
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Provider Business Mailing Address
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Address Line | 20619 FLINTOFF LN
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City | KATY
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State | TX
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Zip | 77449-0403
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Country | US
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Telephone | 504-722-6796
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 13313
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License Number State | LA
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