Provider Demographics
NPI:1003418294
Name:BARCLAY, VICTORIA HELEN
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:HELEN
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 N MAIN ST APT C
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-2465
Mailing Address - Country:US
Mailing Address - Phone:513-283-5535
Mailing Address - Fax:
Practice Address - Street 1:318 RUDOLPH RD
Practice Address - Street 2:
Practice Address - City:NORTH BALTIMORE
Practice Address - State:OH
Practice Address - Zip Code:45872-9734
Practice Address - Country:US
Practice Address - Phone:419-575-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8702329OtherDODD
OH0371604Medicaid