Provider Demographics
NPI:1093876302
Name:LATOUR, VICTORIA BEDIGIAN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:BEDIGIAN
Last Name:LATOUR
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 S 16TH PLACE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-8009
Mailing Address - Country:US
Mailing Address - Phone:508-615-8678
Mailing Address - Fax:508-615-8678
Practice Address - Street 1:9015 S 16TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-8009
Practice Address - Country:US
Practice Address - Phone:508-615-8678
Practice Address - Fax:508-615-8678
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6368235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA71077OtherHARVARD PILGRIM
MASP0138OtherBLUE CROSS BLUE SHIELD