Provider Demographics
NPI:1740609262
Name:BRATTAIN, VICTORIA (NBC-HIS, COHC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BRATTAIN
Suffix:
Gender:F
Credentials:NBC-HIS, COHC
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:BOTTOMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NBC-HIS, COHC
Mailing Address - Street 1:1356 BENVENUE RD.
Mailing Address - Street 2:BENVENUE PLAZA
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804
Mailing Address - Country:US
Mailing Address - Phone:252-442-3335
Mailing Address - Fax:
Practice Address - Street 1:1356 BENVENUE RD.
Practice Address - Street 2:BENVENUE PLAZA
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804
Practice Address - Country:US
Practice Address - Phone:252-442-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-11
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC943237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist