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Individual

MRS. TERESITA VILLEGAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-A

Contact information

Practice address
3776 HIGHWAY 5, DOUGLASVILLE, GA 30135-3368
(770) 714-8644
(678) 505-8012
Mailing address
PO BOX 5455, DOUGLASVILLE, GA 30154
(770) 714-8644
(678) 505-8012

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD003145
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000804757A
GA
Enumeration date
04/03/2007
Last updated
03/01/2016
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