Individual
RODOLFO LUIS VILLEGAS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7200
Mailing address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
AK
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1712687
—
AK
Enumeration date
05/03/2019
Last updated
06/19/2025
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