Provider Demographics
NPI:1376372052
Name:ROWE, VICTORIA (ADDC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:ADDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4388 MONTEBELLO DR APT 605
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-2854
Mailing Address - Country:US
Mailing Address - Phone:719-482-4669
Mailing Address - Fax:
Practice Address - Street 1:6430 BROOK PARK DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1432
Practice Address - Country:US
Practice Address - Phone:855-961-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COADDC.0000329101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)