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General NPI Number Information
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NPI Number | 1922654078
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Entity Type | Organization
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Legal Business Name | VICTORY THERAPY SOLUTIONS LLC
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 3601 SW 117TH AVE APT 405
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City | MIAMI
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State | FL
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Zip | 33175-1765
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Country | US
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Telephone | 305-793-9783
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 SW 117TH AVE APT 405
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City | MIAMI
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State | FL
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Zip | 33175-1765
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Country | US
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Telephone | 305-793-9783
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ANNA JANE
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Credential | MS CCC SLP
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Telephone | 305-793-9783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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