Provider Demographics
NPI:1679832273
Name:VARNEY, VICTORIA LEIGH (NCLMT)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LEIGH
Last Name:VARNEY
Suffix:
Gender:F
Credentials:NCLMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WENHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01984-1415
Mailing Address - Country:US
Mailing Address - Phone:978-468-4294
Mailing Address - Fax:
Practice Address - Street 1:162 MAIN ST
Practice Address - Street 2:
Practice Address - City:WENHAM
Practice Address - State:MA
Practice Address - Zip Code:01984-1415
Practice Address - Country:US
Practice Address - Phone:978-468-4294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58174400000X
MA5372174400000X
MA8973174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty