Provider Demographics
NPI:1568201796
Name:HERRERA, VICTORIA FAITH (MA, MT-BC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:FAITH
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ASTON
Mailing Address - State:PA
Mailing Address - Zip Code:19014-2011
Mailing Address - Country:US
Mailing Address - Phone:732-770-5525
Mailing Address - Fax:
Practice Address - Street 1:1880 JOHN F KENNEDY BLVD STE 1110
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-7447
Practice Address - Country:US
Practice Address - Phone:215-544-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health