Provider Demographics
NPI:1003246984
Name:CHACHULA, DESIREE VILLARROEL (PHD (ABD))
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:VILLARROEL
Last Name:CHACHULA
Suffix:
Gender:F
Credentials:PHD (ABD)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:TERRA CEIA
Mailing Address - State:FL
Mailing Address - Zip Code:34250-0298
Mailing Address - Country:US
Mailing Address - Phone:941-527-6260
Mailing Address - Fax:
Practice Address - Street 1:50 ISLAND CT
Practice Address - Street 2:
Practice Address - City:TERRA CEIA
Practice Address - State:FL
Practice Address - Zip Code:34250-0298
Practice Address - Country:US
Practice Address - Phone:941-527-6260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL869247235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist