Provider Demographics
NPI:1447810999
Name:VALLIER SCOTT, LAKEISHA DEWYNE
Entity type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:DEWYNE
Last Name:VALLIER SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16519 REGAL EXETER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1446
Mailing Address - Country:US
Mailing Address - Phone:832-434-2850
Mailing Address - Fax:
Practice Address - Street 1:16519 REGAL EXETER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-1446
Practice Address - Country:US
Practice Address - Phone:832-434-2850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator