Provider Demographics
NPI:1831733781
Name:TINGLEY, VICTORIA (SLP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:TINGLEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MARSHELLEN DR STE A
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6900
Mailing Address - Country:US
Mailing Address - Phone:843-379-5333
Mailing Address - Fax:843-379-5338
Practice Address - Street 1:990 RIBAUT RD STE 210
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-8011
Practice Address - Country:US
Practice Address - Phone:843-522-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6551235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6551OtherSC SLP LICENSE