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General NPI Number Information
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NPI Number | 1881584316
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Entity Type | Individual
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Provider Name | VICTORIA FOTINI DAVLANTES MT-BC
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Gender | Female
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 3500 11 MILE RD STE C
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City | BERKLEY
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State | MI
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Zip | 48072-1225
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Country | US
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Telephone | 248-459-1340
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 11 MILE RD STE C
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City | BERKLEY
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State | MI
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Zip | 48072-1225
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Country | US
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Telephone |
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | 17767
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License Number State | IN
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