Provider Demographics
NPI:1639324916
Name:VILLEGAS, MICHELLE BUCHANAN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:BUCHANAN
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 E 108TH ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4206
Mailing Address - Country:US
Mailing Address - Phone:212-410-4015
Mailing Address - Fax:212-369-9908
Practice Address - Street 1:309 E 108TH ST APT 2B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4206
Practice Address - Country:US
Practice Address - Phone:212-410-4015
Practice Address - Fax:212-369-9908
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-30
Last Update Date:2008-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007124235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist