Individual
TAMMY VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPC-S
Contact information
Practice address
1540 REAGAN AVE, WAXAHACHIE, TX 75165-1262
(817) 980-7322
Mailing address
1540 REAGAN AVE, WAXAHACHIE, TX 75165-1262
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87-3448026
—
TX
Enumeration date
02/07/2022
Last updated
02/07/2022
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