Provider Demographics
NPI:1043541873
Name:ROBLES-VILLACRUCIS, RAMONA L (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RAMONA
Middle Name:L
Last Name:ROBLES-VILLACRUCIS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MS
Other - First Name:RAMONA
Other - Middle Name:L
Other - Last Name:ROBLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:21954 75TH AVE
Mailing Address - Street 2:234-A1 (1ST FLOOR)
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3044
Mailing Address - Country:US
Mailing Address - Phone:718-464-3236
Mailing Address - Fax:718-464-3236
Practice Address - Street 1:18508 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1700
Practice Address - Country:US
Practice Address - Phone:718-264-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011203235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist