Healthcare Provider Details

I. General information

NPI: 1285565267
Provider Name (Legal Business Name): VICTORIA KUCHERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10555 SLEEMAN CREEK RD
LOLO MT
59847-8515
US

IV. Provider business mailing address

721 STEPHENS AVE
MISSOULA MT
59801-3808
US

V. Phone/Fax

Practice location:
  • Phone: 406-936-0212
  • Fax: 406-290-9961
Mailing address:
  • Phone: 423-631-7718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPRD-LTD-LIC-294
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: