Provider Demographics
NPI:1639753957
Name:STANLEY, VICTORIA BROOKE
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:BROOKE
Last Name:STANLEY
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 1:200 NORTHVIEW PLZ
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-3173
Mailing Address - Country:US
Mailing Address - Phone:336-818-0607
Mailing Address - Fax:
Practice Address - Street 1:200 NORTHVIEW PLZ
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3173
Practice Address - Country:US
Practice Address - Phone:336-818-0607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)