Provider Demographics
NPI:1467958009
Name:HERRING, VICTORIA ROSE LOVETT (SLP)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ROSE LOVETT
Last Name:HERRING
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:ROSE
Other - Last Name:LOVETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:53 LOGANBERRY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2303
Mailing Address - Country:US
Mailing Address - Phone:229-560-6600
Mailing Address - Fax:888-841-9040
Practice Address - Street 1:200 W MOORE ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2919
Practice Address - Country:US
Practice Address - Phone:229-253-8500
Practice Address - Fax:229-253-8522
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8429235Z00000X
GASLP010776235Z00000X
FLSA16816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist