Provider Demographics
NPI:1801440482
Name:ALVARENGA VILLATORO, JENNY (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:ALVARENGA VILLATORO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 MONTEREY SQ
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-2891
Mailing Address - Country:US
Mailing Address - Phone:201-572-0989
Mailing Address - Fax:
Practice Address - Street 1:308 MONTEREY SQ
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-2891
Practice Address - Country:US
Practice Address - Phone:201-572-0989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16795235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist