Provider Demographics
NPI:1508056870
Name:ALDEEN, VICTORIA LYNNE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:LYNNE
Last Name:ALDEEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:VICKI
Other - Middle Name:LYNNE
Other - Last Name:TYNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:3405 EL SALIDO PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-886-3374
Mailing Address - Fax:512-549-4822
Practice Address - Street 1:3405 EL SALIDO PKWY
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5640
Practice Address - Country:US
Practice Address - Phone:512-886-3374
Practice Address - Fax:512-549-4822
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0019X
TX103542225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1508056870OtherNPI NUMBER