Provider Information for 1487176632
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VICTORIA VITULLO BAKER MA, CRC, LPC
Other Names:Professional Name:VICTORIA VITULLO MA, CRC, LPCSex: Female
NPI: 1487176632
Last Updated: 2020-01-02
Certification Date: 2020-01-02
Certification Date: 2020-01-02
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1487176632 | ||||||||||||
| Enumeration Date | 2017-07-10 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 45 HENNIG DR PITTSBURGH, PA 15236-1567 United States Phone: 412-956-4500 | Fax: | ||||||||||||
| Primary Practice Address | 45 HENNIG DR PITTSBURGH, PA 15236-1567 United States Phone: 412-956-4500 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 666 WASHINGTON RD | ||||||||||||
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