Individual
SHANTAI NICHELLE LAMAQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13782 BEAR VALLEY RD D3, #106, VICTORVILLE, CA 92392
(760) 220-2839
Mailing address
13782 BEAR VALLEY RD D3, #106, VICTORVILLE, CA 92392
(760) 220-2839
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
20024
CA
Other
Enumeration date
08/15/2023
Last updated
11/04/2025
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