Doctor Name: | MS. MONIQUE MICHELLE VILLASENOR |
NPI Number: | 1174879308 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 146011170 |
Business Practice Address: | 1219 W Roosevelt Rd Maywood, IL - 601534046 |
Business Phone Number: | 7085317950 |
Business Fax Number: | |
Mailing Address: | 2160 S 1st Ave, MAYWOOD |
State: | IL |
Postal Code: | 601533328 |
Phone Number: | 7085317950 |
Fax Number: | |
NPI Enumeration Date: | 07/25/2012 |
NPI Last Update Date: | 07/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146011170 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |