Provider Demographics
NPI:1316589476
Name:GILLIAM, VICTORIA (MPH, CHES, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:GILLIAM
Suffix:
Gender:F
Credentials:MPH, CHES, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:202-893-6206
Mailing Address - Fax:
Practice Address - Street 1:2101 E JEFFERSON ST FL 2
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4908
Practice Address - Country:US
Practice Address - Phone:202-893-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator