Provider Demographics
NPI:1497942627
Name:CANE, VICTORIA ELAINE (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ELAINE
Last Name:CANE
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-4309
Mailing Address - Country:US
Mailing Address - Phone:269-598-5861
Mailing Address - Fax:
Practice Address - Street 1:530 NICHOLS RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-2946
Practice Address - Country:US
Practice Address - Phone:269-598-5861
Practice Address - Fax:888-889-7312
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014776103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical