Provider Demographics
NPI:1083421705
Name:VILLARREAL, ROXANNA ELIZABETH
Entity type:Individual
Prefix:
First Name:ROXANNA
Middle Name:ELIZABETH
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25977 E FROST CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2422
Mailing Address - Country:US
Mailing Address - Phone:720-819-3335
Mailing Address - Fax:
Practice Address - Street 1:25977 E FROST CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-2422
Practice Address - Country:US
Practice Address - Phone:720-819-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0022818101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor