Provider Demographics
NPI:1952886764
Name:VILLANTE, KAYLA C
Entity Type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:C
Last Name:VILLANTE
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 1:25 MARGARET BLVD
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3105
Mailing Address - Country:US
Mailing Address - Phone:516-317-1345
Mailing Address - Fax:
Practice Address - Street 1:75 MORTON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-5750
Practice Address - Country:US
Practice Address - Phone:212-295-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist