Provider Demographics
NPI:1073880985
Name:VILLALBA, JOSE ARLEY JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ARLEY
Last Name:VILLALBA
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OLD ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-1394
Mailing Address - Country:US
Mailing Address - Phone:336-282-3625
Mailing Address - Fax:
Practice Address - Street 1:234C E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2704
Practice Address - Country:US
Practice Address - Phone:336-899-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-20
Last Update Date:2011-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8875101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health