Provider Demographics
NPI:1760022131
Name:VALLOT, QIANESHA (LCSW)
Entity Type:Individual
Prefix:
First Name:QIANESHA
Middle Name:
Last Name:VALLOT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7902 ROCK ROSE ST APT 7
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-2060
Mailing Address - Country:US
Mailing Address - Phone:773-297-1385
Mailing Address - Fax:
Practice Address - Street 1:1941 EAST RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-6010
Practice Address - Country:US
Practice Address - Phone:713-486-2700
Practice Address - Fax:713-486-2721
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX690281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical