Basic Information
| Provider Information | |||||||||
| NPI: | 1891305330 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WESTERMANN | ||||||||
| FirstName: | VICTORIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2104 BELMONT PARK DR | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762103647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9723221337 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4491 LONG PRAIRIE RD UNIT 300 | ||||||||
| Address2: | |||||||||
| City: | FLOWER MOUND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750281795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2818263382 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2020 | ||||||||
| LastUpdateDate: | 10/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 3568 | TX | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.