Individual
VICTORIA VANDEUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 HARBISON WAY, COLUMBIA, SC 29212-3402
(803) 601-0816
Mailing address
1220 HAMRICK ST, COLUMBIA, SC 29201-4563
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-49730
SC
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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