Provider Demographics
NPI:1316001589
Name:VILLEGAS, SHERYL MARIE (MED, PC)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:MARIE
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:MED, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 BEALL AVE
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-3589
Mailing Address - Country:US
Mailing Address - Phone:330-262-7836
Mailing Address - Fax:330-262-2867
Practice Address - Street 1:521 BEALL AVE
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-3589
Practice Address - Country:US
Practice Address - Phone:330-262-7836
Practice Address - Fax:330-262-2867
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC7412101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional