Provider Demographics
NPI:1952055089
Name:EARLENBAUGH, VICTORIA MARIE
Entity Type:Individual
Prefix:PROF
First Name:VICTORIA
Middle Name:MARIE
Last Name:EARLENBAUGH
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 1:897 BURBANK AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-1437
Mailing Address - Country:US
Mailing Address - Phone:330-256-5465
Mailing Address - Fax:
Practice Address - Street 1:23701 MILES RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5473
Practice Address - Country:US
Practice Address - Phone:216-763-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker