Organization
VICTORY PSYCH CONSULTATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YAHAYA A ANIMASHAUN APN (NURSE PRACTIONER)
(908) 247-8768
Entity
Organization
Contact information
Practice address
188 FRIES MILL RD STE E2, BLACKWOOD, NJ 08012-2015
(551) 214-4475
(646) 490-8780
Mailing address
10 ETON DR, SEWELL, NJ 08080-2482
(908) 247-8768
(646) 490-8780
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/14/2021
Last updated
07/25/2024
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