1831733781 NPI number — VICTORIA TINGLEY SLP

Table of content: VICTORIA TINGLEY SLP (NPI 1831733781)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831733781 NPI number — VICTORIA TINGLEY SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TINGLEY
Provider First Name:
VICTORIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831733781
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 MARSHELLEN DR STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAUFORT
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29902-6900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-379-5333
Provider Business Mailing Address Fax Number:
843-379-5338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
990 RIBAUT RD STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAUFORT
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29902-8011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-522-5900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/04/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  6551 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6551 . This is a "SC SLP LICENSE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".