Provider Demographics
NPI:1376256636
Name:VILLAFRANCO, MOLLY (MS-CCC, SLP)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:VILLAFRANCO
Suffix:
Gender:F
Credentials:MS-CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4808
Mailing Address - Country:US
Mailing Address - Phone:201-790-1543
Mailing Address - Fax:
Practice Address - Street 1:510 E 141ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2753
Practice Address - Country:US
Practice Address - Phone:718-585-3071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031995-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist