Provider Demographics
NPI:1093017535
Name:SPIRE, VICTORIA ANN
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ANN
Last Name:SPIRE
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 1:209 MOREHOUSE ST
Mailing Address - Street 2:
Mailing Address - City:BARNARD
Mailing Address - State:MO
Mailing Address - Zip Code:64423-8201
Mailing Address - Country:US
Mailing Address - Phone:660-652-3727
Mailing Address - Fax:660-652-3714
Practice Address - Street 1:209 MOREHOUSE ST
Practice Address - Street 2:
Practice Address - City:BARNARD
Practice Address - State:MO
Practice Address - Zip Code:64423-8201
Practice Address - Country:US
Practice Address - Phone:660-652-3727
Practice Address - Fax:660-652-3714
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO463132720Medicaid