Provider Demographics
NPI:1609597780
Name:LEWIS, VICTORIA BETH (MS SLP-INTERN)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:BETH
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS SLP-INTERN
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:413 N GASTON DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:620 N MURPHY RD
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4302
Practice Address - Country:US
Practice Address - Phone:469-752-7035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist