Provider Demographics
NPI:1871632463
Name:VILLAMIL-RUBIN, AURA ELIZ (PHD)
Entity Type:Individual
Prefix:DR
First Name:AURA
Middle Name:ELIZ
Last Name:VILLAMIL-RUBIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:AURA
Other - Middle Name:ELIZ
Other - Last Name:VILLAMIL-RUBIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1982 E MCNAIR DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-4922
Mailing Address - Country:US
Mailing Address - Phone:480-755-8295
Mailing Address - Fax:
Practice Address - Street 1:950 N SUNVALLEY BLVD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-3801
Practice Address - Country:US
Practice Address - Phone:480-472-3976
Practice Address - Fax:480-472-3999
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3825103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ585804Medicaid