Provider Demographics
NPI:1477842672
Name:VILLEGAS, MARYCELIA ELIZABETH (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARYCELIA
Middle Name:ELIZABETH
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:MARYCELIA
Other - Middle Name:E
Other - Last Name:SEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 W US HIGHWAY 223
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-8439
Mailing Address - Country:US
Mailing Address - Phone:517-263-3378
Mailing Address - Fax:517-263-4527
Practice Address - Street 1:1800 W US HIGHWAY 223
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-8439
Practice Address - Country:US
Practice Address - Phone:517-263-3378
Practice Address - Fax:517-263-4527
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 10257235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0849916Medicaid