Provider Demographics
NPI:1518667021
Name:PARKER, VICTORIA JOANN
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JOANN
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:JOANN
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1317 LITHIA SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-8336
Mailing Address - Country:US
Mailing Address - Phone:714-797-4289
Mailing Address - Fax:
Practice Address - Street 1:1317 LITHIA SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-8336
Practice Address - Country:US
Practice Address - Phone:714-797-4289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician