Provider Demographics
NPI:1497282735
Name:OSBORNE, VICTORIA (MA, CCC-SLP, CNT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:MA, CCC-SLP, CNT
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:WISEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:221 TIMOTHY DR
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-9514
Mailing Address - Country:US
Mailing Address - Phone:606-402-0644
Mailing Address - Fax:
Practice Address - Street 1:278 SOUTHLAND DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1940
Practice Address - Country:US
Practice Address - Phone:859-287-2996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No374J00000XNursing Service Related ProvidersDoula