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NPI Code Detail

MEDICARE: VICTORIA OPP

MEDICARE: VICTORIA OPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-24-338278

General Provider Information

NPI Number : 1457107815
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA OPP
Provider Business Mailing Address
First Line : 9153 W 133RD ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66213-4333
Country : US
Telephone Number : 913-257-5185
Fax Number : 833-340-7117
Provider Business Practice Location Address
First Line : 7500 W 161ST ST
Second Line :
City : STILWELL
State : KS
Zip : 66085-9387
Country : US
Telephone Number : 913-257-5185
Fax Number : 833-340-7117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2024
Last Update Date : 04/26/2024

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Directions to “ VICTORIA OPP ” Practice Location

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