Provider Demographics
NPI:1639409451
Name:VALERA, QUANIQUE LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:QUANIQUE
Middle Name:LEE
Last Name:VALERA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:QUANIQUE
Other - Middle Name:SHANTEL
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QUANIQUE LEE TALONE
Mailing Address - Street 1:801 N MAGNOLIA AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3844
Mailing Address - Country:US
Mailing Address - Phone:321-800-2874
Mailing Address - Fax:
Practice Address - Street 1:801 N MAGNOLIA AVE STE 402
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3844
Practice Address - Country:US
Practice Address - Phone:321-800-2874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 108091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical