Provider Demographics
NPI:1841024437
Name:CATALA VILLANUEVA, PAOLA MARIE
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:MARIE
Last Name:CATALA VILLANUEVA
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 1:11201 EVERBLADES PKWY APT 202
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-9566
Mailing Address - Country:US
Mailing Address - Phone:787-354-4042
Mailing Address - Fax:
Practice Address - Street 1:519 AVENIDA CESAR E CHAVEZ
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2133
Practice Address - Country:US
Practice Address - Phone:888-913-1910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ12161235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist