Healthcare Provider Details

I. General information

NPI: 1760948145
Provider Name (Legal Business Name): VICTORIA L LOCKWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2019
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 MADISON ROAD
CINCINNATI OH
45227-1428
US

IV. Provider business mailing address

4850 MADISON ROAD
CINCINNATI OH
45227-1428
US

V. Phone/Fax

Practice location:
  • Phone: 513-832-2884
  • Fax: 513-351-1780
Mailing address:
  • Phone: 513-832-2884
  • Fax: 513-351-1780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2005548
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: