Provider Demographics
NPI:1942544788
Name:VILLEGAS, EMILY KRISTIN (RD, CLC)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KRISTIN
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:RD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ANGELO CT
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-1446
Mailing Address - Country:US
Mailing Address - Phone:401-241-5464
Mailing Address - Fax:
Practice Address - Street 1:438 BROADWAY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1622
Practice Address - Country:US
Practice Address - Phone:401-742-0947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-17
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1008483133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered