Provider Demographics
NPI:1114295391
Name:MILHOUSE, VICTORIA LYNZIE
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNZIE
Last Name:MILHOUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:LYNZIE
Other - Last Name:HOITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:965 COPPET ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4718
Mailing Address - Country:US
Mailing Address - Phone:907-799-0607
Mailing Address - Fax:
Practice Address - Street 1:965 COPPET ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4718
Practice Address - Country:US
Practice Address - Phone:907-799-0607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker