Provider Demographics
NPI:1083875603
Name:VILLEC, JENNIFER BENSON (MS/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BENSON
Last Name:VILLEC
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:408 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2961
Mailing Address - Country:US
Mailing Address - Phone:302-463-7140
Mailing Address - Fax:
Practice Address - Street 1:12 LANDERS LN
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-2023
Practice Address - Country:US
Practice Address - Phone:302-429-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE01-0000805235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist