Provider Demographics
NPI:1811046063
Name:TOMPKINS, VICTORIA ANTIGIOVANNI (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANTIGIOVANNI
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 HIGH MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06455-1269
Mailing Address - Country:US
Mailing Address - Phone:860-888-2890
Mailing Address - Fax:860-540-1130
Practice Address - Street 1:22 PINE ST STE 205
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-6949
Practice Address - Country:US
Practice Address - Phone:860-470-6204
Practice Address - Fax:860-540-1130
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001150106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist