Organization
KENNETH J. VICTOR, PSYD, HSPP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH JOSEPH VICTOR PSY.D. (OWNER)
(812) 238-7384
Entity
Organization
Contact information
Practice address
2321 N 10TH ST, TERRE HAUTE, IN 47804-2310
(812) 238-7384
(812) 238-7002
Mailing address
2321 N 10TH ST, TERRE HAUTE, IN 47804-2310
(812) 238-7384
(812) 238-7002
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041162
IN
Other
Enumeration date
01/11/2006
Last updated
11/19/2007
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