Provider Demographics
NPI:1568606986
Name:MCBRIDE, VICTORIA ANN (SPEECH & LANGUAGE PA)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ANN
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:SPEECH & LANGUAGE PA
Other - Prefix:MRS
Other - First Name:VICTORIA
Other - Middle Name:ANN
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED CCC LSP
Mailing Address - Street 1:180 ACADEMY ST.
Mailing Address - Street 2:THE LIONHEART SCHOOL
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004
Mailing Address - Country:US
Mailing Address - Phone:770-772-4555
Mailing Address - Fax:770-772-1871
Practice Address - Street 1:180 ACADEMY ST.
Practice Address - Street 2:THE LIONHEART SCHOOL
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004
Practice Address - Country:US
Practice Address - Phone:770-772-4555
Practice Address - Fax:770-772-1871
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003130235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist