Provider Demographics
NPI:1053953752
Name:TARPEH, VICTORIA W (MS, LBS)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:W
Last Name:TARPEH
Suffix:
Gender:F
Credentials:MS, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6742 GUYER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-2611
Mailing Address - Country:US
Mailing Address - Phone:267-353-6725
Mailing Address - Fax:
Practice Address - Street 1:6742 GUYER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-2611
Practice Address - Country:US
Practice Address - Phone:267-353-6725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001355106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1972OtherDATE OF BIRTH