Provider Demographics
NPI:1003373499
Name:VILLEMEZ, ABBIE CHRISTINE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:CHRISTINE
Last Name:VILLEMEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 N 29TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5003
Mailing Address - Country:US
Mailing Address - Phone:602-471-0624
Mailing Address - Fax:
Practice Address - Street 1:1910 S STAPLEY DR STE 119
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6675
Practice Address - Country:US
Practice Address - Phone:623-263-3260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP16167235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZSLP16167OtherARIZONA DEPARTMENT OF HEALTH SERVICES