Provider Demographics
NPI:1548307069
Name:HARPER, VICTORIA LYNN (OTD, OTRL)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LYNN
Last Name:HARPER
Suffix:
Gender:F
Credentials:OTD, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 ARLINGTON EXPY APT 3611
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-6876
Mailing Address - Country:US
Mailing Address - Phone:904-729-8646
Mailing Address - Fax:
Practice Address - Street 1:5350 ARLINGTON EXPY APT 3611
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-6876
Practice Address - Country:US
Practice Address - Phone:904-729-8646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT1782225X00000X
TN3733225X00000X
FLOT14638225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03138372Medicaid
MS670000054Medicare ID - Type UnspecifiedPROVIDER