Provider Demographics
| NPI: | 1457835878 |
|---|---|
| Name: | WOMEN OF VALOR INC |
| Entity Type: | Organization |
| Organization Name: | WOMEN OF VALOR INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | REHAB PRACTITIONER |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | SHANEQUIA |
| Authorized Official - Middle Name: | NICKI |
| Authorized Official - Last Name: | CLEMONS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 210-606-2319 |
| Mailing Address - Street 1: | 19547 RIPPLING BROOK LN |
| Mailing Address - Street 2: | |
| Mailing Address - City: | TOMBALL |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77375-7603 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 210-606-2319 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 19547 RIPPLING BROOK LN |
| Practice Address - Street 2: | |
| Practice Address - City: | TOMBALL |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77375-7603 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 210-606-2319 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2018-09-21 |
| Last Update Date: | 2018-12-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | Group - Multi-Specialty | |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 175T00000X | Other Service Providers | Peer Specialist | Group - Multi-Specialty | |
| No | 2084B0040X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | Group - Multi-Specialty |
| No | 2084F0202X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Forensic Psychiatry | Group - Multi-Specialty |
| No | 2084P0005X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurodevelopmental Disabilities | Group - Multi-Specialty |
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health | Group - Multi-Specialty |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
| No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | Group - Multi-Specialty |
| No | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | Group - Multi-Specialty | |
| No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child | Group - Multi-Specialty |
