Provider Demographics
NPI:1780474577
Name:CHAMBERLAIN, VICTORIA LEE
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LEE
Last Name:CHAMBERLAIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ASHBURNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01430-1625
Mailing Address - Country:US
Mailing Address - Phone:978-602-4185
Mailing Address - Fax:
Practice Address - Street 1:9 S HIGH ST
Practice Address - Street 2:
Practice Address - City:ASHBURNHAM
Practice Address - State:MA
Practice Address - Zip Code:01430-1625
Practice Address - Country:US
Practice Address - Phone:978-602-4185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician