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General NPI Number Information
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NPI Number | 1720975691
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Entity Type | Individual
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Provider Name | VICTORIA WADE MA, CCC-A
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 30 W MCCREIGHT AVE
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City | SPRINGFIELD
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State | OH
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Zip | 45504-1842
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Country | US
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Telephone | 937-609-7936
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Fax |
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Provider Business Mailing Address
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Address Line | 8775 CHAMPION CT
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City | DAYTON
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State | OH
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Zip | 45424-1240
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Country | US
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Telephone | 937-609-7936
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Fax |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A.00784
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License Number State | OH
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