Provider Demographics
NPI:1316533888
Name:CHASSIN, VICTORIA
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:CHASSIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TORY
Other - Middle Name:
Other - Last Name:CHASSIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1053 GOVERNMENT ST APT 304
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-2423
Mailing Address - Country:US
Mailing Address - Phone:917-817-6231
Mailing Address - Fax:
Practice Address - Street 1:75 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3271
Practice Address - Country:US
Practice Address - Phone:251-460-7149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
AL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician