Provider Demographics
NPI:1285470989
Name:OCHOA, VICTORIA MELISSA
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MELISSA
Last Name:OCHOA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6760 W GUNNISON ST
Mailing Address - Street 2:
Mailing Address - City:HARWOOD HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60706-4054
Mailing Address - Country:US
Mailing Address - Phone:773-398-6817
Mailing Address - Fax:
Practice Address - Street 1:6760 W GUNNISON ST
Practice Address - Street 2:
Practice Address - City:HARWOOD HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60706-4054
Practice Address - Country:US
Practice Address - Phone:773-398-6817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2569438222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist