Provider Demographics
NPI:1871095927
Name:VILLARREAL, ROSA EMILIA (SLP ASSISTANT)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:EMILIA
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:SLP ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 S GREENE RD
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4753
Mailing Address - Country:US
Mailing Address - Phone:956-424-3646
Mailing Address - Fax:956-580-2311
Practice Address - Street 1:208 DIAMOND AVE. STE 2
Practice Address - Street 2:
Practice Address - City:LA JOYA
Practice Address - State:TX
Practice Address - Zip Code:78560
Practice Address - Country:US
Practice Address - Phone:956-424-3646
Practice Address - Fax:956-580-2311
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344712355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant