Provider Demographics
NPI:1346817350
Name:HERMAN, VICTORIA ANN
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANN
Last Name:HERMAN
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 1:1533 CADILLAC BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-3107
Mailing Address - Country:US
Mailing Address - Phone:586-395-9069
Mailing Address - Fax:
Practice Address - Street 1:1533 CADILLAC BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3107
Practice Address - Country:US
Practice Address - Phone:586-395-9069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker