Provider Demographics
NPI:1629827878
Name:VILLANUEVA, AYLIN CELESTE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:AYLIN
Middle Name:CELESTE
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5422 LONESOME BIKER LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1508
Mailing Address - Country:US
Mailing Address - Phone:702-802-9554
Mailing Address - Fax:
Practice Address - Street 1:2904 W HORIZON RIDGE PKWY STE 330
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5015
Practice Address - Country:US
Practice Address - Phone:702-564-4116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-4180235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist