Provider Demographics
NPI:1417353756
Name:VIOSCA, VALERIE (LAC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:VIOSCA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 HIGH RD
Mailing Address - Street 2:
Mailing Address - City:CUCHARA
Mailing Address - State:CO
Mailing Address - Zip Code:81055
Mailing Address - Country:US
Mailing Address - Phone:719-742-5403
Mailing Address - Fax:
Practice Address - Street 1:4608 FRERET ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-717-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU837171100000X
COMT.0005349225700000X
LAACA200010171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty