Provider Demographics
NPI:1003874678
Name:HUESTON, VICTORIA KENT (MSPT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:KENT
Last Name:HUESTON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 SAINT PAUL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-6865
Mailing Address - Country:US
Mailing Address - Phone:401-474-1293
Mailing Address - Fax:
Practice Address - Street 1:140 POINT JUDITH RD
Practice Address - Street 2:
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882
Practice Address - Country:US
Practice Address - Phone:401-789-2077
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT07136174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist