Organization
VILLA PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTINA VILLARREAL MS, CCC-SLP (OWNER)
(208) 503-6173
Entity
Organization
Contact information
Practice address
8052 W MAIN ST UNIT 107, RATHDRUM, ID 83858-4915
(208) 503-6173
(208) 712-6808
Mailing address
PO BOX 793, RATHDRUM, ID 83858-0793
(208) 503-6173
(208) 712-6808
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
04/04/2022
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