Provider Demographics
NPI:1801687785
Name:WILLINGHAM, VICTORIA NICOLE (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:NICOLE
Last Name:WILLINGHAM
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 19TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1831
Mailing Address - Country:US
Mailing Address - Phone:865-331-2020
Mailing Address - Fax:
Practice Address - Street 1:501 19TH ST STE 401
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1831
Practice Address - Country:US
Practice Address - Phone:865-331-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN368170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS