Individual
TAYLOR VILLARREAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2505 ARDMORE ST SE, GRAND RAPIDS, MI 49506-4924
(616) 559-1054
Mailing address
2505 ARDMORE ST SE, GRAND RAPIDS, MI 49506-4924
(616) 559-1054
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101006241
MI
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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