Provider Demographics
NPI:1205123999
Name:BERGER, VICTORIA (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W CROSBY RD STE 136
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-6904
Mailing Address - Country:US
Mailing Address - Phone:972-237-0100
Mailing Address - Fax:
Practice Address - Street 1:1000 W CROSBY RD STE 136
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-6904
Practice Address - Country:US
Practice Address - Phone:972-237-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3762225XP0200X
TX119522225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics