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General NPI Number Information
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NPI Number | 1720141815
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Entity Type | Individual
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Provider Name | DR. VICTORIA O SOYANNWO
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Gender | Female
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 05/26/2018
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Provider Practice Location Address
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Address Line | 1601 E APACHE PARK PL
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City | TUCSON
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State | AZ
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Zip | 85714-1775
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Country | US
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Telephone | 520-746-0260
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Fax | 520-295-0834
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Provider Business Mailing Address
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Address Line | 6050 N CORONA RD
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City | TUCSON
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State | AZ
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Zip | 85704-1096
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Country | US
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Telephone | 520-682-4111
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Fax | 520-682-4570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 42824
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License Number State | AZ
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