Provider Demographics
NPI:1851881742
Name:WINPHRIE, VICTORIA LYNN (CDCA, QBHS)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LYNN
Last Name:WINPHRIE
Suffix:
Gender:F
Credentials:CDCA, QBHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44510-1457
Mailing Address - Country:US
Mailing Address - Phone:330-519-7447
Mailing Address - Fax:
Practice Address - Street 1:209 W WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1866
Practice Address - Country:US
Practice Address - Phone:330-787-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH812009857Medicaid