Provider Demographics
NPI:1952124281
Name:WHITE, VICTORIA JULIA-EGLAH
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JULIA-EGLAH
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12007 QUARTETTE LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4355
Mailing Address - Country:US
Mailing Address - Phone:240-595-0541
Mailing Address - Fax:
Practice Address - Street 1:9301 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3115
Practice Address - Country:US
Practice Address - Phone:240-296-5848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool