Healthcare Provider Details

I. General information

NPI: 1578222394
Provider Name (Legal Business Name): VICTORIA SOM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2021
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 SE PARKWAY CT
FRANKLIN TN
37064-3968
US

IV. Provider business mailing address

1607 KENSINGTON DR
MURFREESBORO TN
37130-5949
US

V. Phone/Fax

Practice location:
  • Phone: 615-790-0567
  • Fax: 615-595-8030
Mailing address:
  • Phone: 615-294-5830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: