Organization
ALICIA A VICTORY, PSYD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA A VICTORY PSYD (OWNER)
(615) 625-2117
Entity
Organization
Contact information
Practice address
101 WALNUT LN, COLUMBIA, TN 38401
(615) 625-2117
(865) 246-2104
Mailing address
PO BOX 5777, MARYVILLE, TN 37802-5777
(865) 246-2104
(865) 246-2106
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3279
TN
Other
Enumeration date
07/03/2018
Last updated
09/04/2018
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