Provider Demographics
NPI:1740969864
Name:ANYANWU, VICTORIA NKECHI
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:NKECHI
Last Name:ANYANWU
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 1:2061 STONE HEDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-1984
Mailing Address - Country:US
Mailing Address - Phone:971-207-2161
Mailing Address - Fax:
Practice Address - Street 1:2061 STONE HEDGE DR NE
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-1984
Practice Address - Country:US
Practice Address - Phone:971-207-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker