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Individual
MRS. KENDAL C VILLA
Active
Individual
MRS. KENDAL C VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC - SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
103783
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102906
SPEECH LICENSE
TX
05
—
164704201
—
TX
Enumeration date
05/17/2007
Last updated
08/06/2024
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