Provider Demographics
NPI:1720822182
Name:IACOVINO, VICTORIA T (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:T
Last Name:IACOVINO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2735
Mailing Address - Country:US
Mailing Address - Phone:732-501-8443
Mailing Address - Fax:
Practice Address - Street 1:23 KILMER DR
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1563
Practice Address - Country:US
Practice Address - Phone:732-617-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01264100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist