Provider Demographics
NPI:1376797431
Name:VILLARREAL, MARIA IRENE (MS, SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:IRENE
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 NORTHERN LIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-1984
Mailing Address - Country:US
Mailing Address - Phone:956-821-5598
Mailing Address - Fax:
Practice Address - Street 1:4000 NORTHERN LIGHTS AVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-1984
Practice Address - Country:US
Practice Address - Phone:956-821-5598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-15
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104645OtherSTATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY