Provider Demographics
NPI:1265122675
Name:VICTORY SPEECH THERAPY
Entity type:Organization
Organization Name:VICTORY SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HELFRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-594-3481
Mailing Address - Street 1:8132 BLAIR RD
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-3051
Mailing Address - Country:US
Mailing Address - Phone:940-594-3481
Mailing Address - Fax:
Practice Address - Street 1:100 PLAZA PL STE 300
Practice Address - Street 2:
Practice Address - City:NORTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76226-3479
Practice Address - Country:US
Practice Address - Phone:940-594-3481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty