Victoria Elizabeth Blair
Individual provider Active NPI Behavior Analyst · Roanoke, VA
NPI 1306643523 · NPPES record last updated Feb 26, 2025
Key facts
- NPI
- 1306643523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 0133004174 (VA)
- Practice address
- 5673 Airport Rd NW
Roanoke, VA 24012-1119 - Phone
- (434) 515-1194
- NPI assigned
- Feb 26, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0133004174 | VA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intercept Youth Services, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 0133004174 | VA | Yes |
Addresses
Primary practice location
5673 Airport Rd NW
Roanoke, VA 24012-1119
Mailing address
5673 Airport Rd NW
Roanoke, VA 24012-1119
Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.