Individual
KIMBERLY VILLAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 W WASHINGTON AVE, LOVINGTON, NM 88260-4023
(505) 739-2705
Mailing address
PO BOX 672, LOVINGTON, NM 88260-0672
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3424
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75738350
—
NM
Enumeration date
09/20/2006
Last updated
07/08/2007
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