Organization
WOMEN OF VALOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANEQUIA NICKI CLEMONS (REHAB PRACTITIONER)
(210) 606-2319
Entity
Organization
Contact information
Practice address
19547 RIPPLING BROOK LN, TOMBALL, TX 77375-7603
(210) 606-2319
Mailing address
19547 RIPPLING BROOK LN, TOMBALL, TX 77375-7603
(210) 606-2319
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
2084F0202X
Forensic Psychiatry Physician
—
—
2084P0005X
Neurodevelopmental Disabilities Physician
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
09/21/2018
Last updated
12/21/2018
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