| Doctor Name: | MARLENE J VILLECCO |
| NPI Number: | 1003075565 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS |
| License Number: | |
| Business Practice Address: | 500 N Nappanee St Ste 4a Elkhart, IN - 465141502 |
| Business Phone Number: | 5745228992 |
| Business Fax Number: | 5742328968 |
| Mailing Address: | 611 Lincolnway E, SOUTH BEND |
| State: | IN |
| Postal Code: | 466013220 |
| Phone Number: | 5742322255 |
| Fax Number: | 5742328968 |
| NPI Enumeration Date: | 06/09/2008 |
| NPI Last Update Date: | 06/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |