Provider Demographics
NPI:1518654136
Name:ALATORRE GARCIA, VICTORIA RENEE
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:RENEE
Last Name:ALATORRE GARCIA
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 1:3605 SAN CLEMENTE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-7486
Mailing Address - Country:US
Mailing Address - Phone:575-642-4822
Mailing Address - Fax:
Practice Address - Street 1:1123 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6340
Practice Address - Country:US
Practice Address - Phone:575-642-4822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSLPA23005235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist