Provider Demographics
NPI:1891342366
Name:VILLEGAS, ALANA
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 834
Mailing Address - Street 2:
Mailing Address - City:CAPITAN
Mailing Address - State:NM
Mailing Address - Zip Code:88316-0834
Mailing Address - Country:US
Mailing Address - Phone:575-973-7088
Mailing Address - Fax:
Practice Address - Street 1:1500 S AVE K
Practice Address - Street 2:STATION 3, SHROC
Practice Address - City:PORTALES
Practice Address - State:NM
Practice Address - Zip Code:88130-8813
Practice Address - Country:US
Practice Address - Phone:575-562-2175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NMSLPCF22013235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program