| Doctor Name: | MISS VICTORIA ANN LISTON |
| NPI Number: | 1033484449 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BSW, CADC |
| License Number: | |
| Business Practice Address: | 2148 Vadalabene Dr Maryville, IL - 620625632 |
| Business Phone Number: | 6182883100 |
| Business Fax Number: | 6182883371 |
| Mailing Address: | 2148 Vadalabene Dr, MARYVILLE |
| State: | IL |
| Postal Code: | 620625632 |
| Phone Number: | 6182883100 |
| Fax Number: | 6182883371 |
| NPI Enumeration Date: | 03/19/2012 |
| NPI Last Update Date: | 03/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |