Provider Demographics
NPI:1508465923
Name:SELTZER, VICTORIA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SELTZER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 GAYLEY ST APT C206
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3751
Mailing Address - Country:US
Mailing Address - Phone:610-306-9327
Mailing Address - Fax:
Practice Address - Street 1:100 W SIXTH ST STE 305
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2428
Practice Address - Country:US
Practice Address - Phone:484-445-4147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011712101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional