Provider Demographics
NPI:1659796316
Name:HOPSON, VICTORIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:HOPSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 RIDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-6303
Mailing Address - Country:US
Mailing Address - Phone:423-741-1194
Mailing Address - Fax:
Practice Address - Street 1:2029 RIDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-6303
Practice Address - Country:US
Practice Address - Phone:423-741-1194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4955225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist