Provider Demographics
NPI:1609549534
Name:VILLEGAS, RACHEL LEE DEBORAH (MS, LGC)
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:LEE DEBORAH
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:MS, LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CHILDRENS AVE STE 5D
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4637
Mailing Address - Country:US
Mailing Address - Phone:405-271-8685
Mailing Address - Fax:405-271-8697
Practice Address - Street 1:1200 CHILDRENS AVE STE 5D
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-8685
Practice Address - Fax:405-271-8697
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLGC0463170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS