Provider Demographics
NPI:1710728399
Name:DUGGIN, VICTORIA EDEN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:EDEN
Last Name:DUGGIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:EDEN
Other - Last Name:RAINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:TN
Mailing Address - Zip Code:37190-2105
Mailing Address - Country:US
Mailing Address - Phone:615-785-2862
Mailing Address - Fax:
Practice Address - Street 1:50 VALLEY DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190-2105
Practice Address - Country:US
Practice Address - Phone:615-785-2862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8688235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist