Provider Demographics
NPI:1821747221
Name:HART, VICTORIA (CTRS)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 ANDORRA GLEN CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-2523
Mailing Address - Country:US
Mailing Address - Phone:805-403-0884
Mailing Address - Fax:
Practice Address - Street 1:316 ANDORRA GLEN CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-2523
Practice Address - Country:US
Practice Address - Phone:805-403-0884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist