| Kenneth J. Victor, Psyd, Hspp, Llc | |
|
2321 N 10th St Terre Haute IN 47804-2310 | |
| (812) 238-7384 | |
| (812) 238-7002 |
| Full Name | Kenneth J. Victor, Psyd, Hspp, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2321 N 10th St, Terre Haute, Indiana |
| Authorized Official Name and Position | Kenneth Joseph Victor (OWNER) |
| Authorized Official Contact | 8122387384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth J. Victor, Psyd, Hspp, Llc 2321 N 10th St Terre Haute IN 47804-2310 Ph: (812) 238-7384 | Kenneth J. Victor, Psyd, Hspp, Llc 2321 N 10th St Terre Haute IN 47804-2310 Ph: (812) 238-7384 |
| NPI Number | 1639158348 |
|---|---|
| Provider Enumeration Date | 01/11/2006 |
| Last Update Date | 11/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639158348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 20041162 (Indiana) | Primary |
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