Provider Demographics
NPI:1346736766
Name:FACCHIN, VICTORIA WOLFE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:WOLFE
Last Name:FACCHIN
Suffix:
Gender:
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 HILLIS TER
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5812
Mailing Address - Country:US
Mailing Address - Phone:860-885-9286
Mailing Address - Fax:
Practice Address - Street 1:140 MAIN ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3018
Practice Address - Country:US
Practice Address - Phone:845-454-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEST2815235Z00000X
CT006527235Z00000X
NY034047235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist