Provider Demographics
NPI:1851108583
Name:VILLEGAS, CLAUDIA MARCELA (LMT)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:MARCELA
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1566 BEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BONNER
Mailing Address - State:MT
Mailing Address - Zip Code:59823-9161
Mailing Address - Country:US
Mailing Address - Phone:619-346-2068
Mailing Address - Fax:
Practice Address - Street 1:2409 DEARBORN AVE STE E
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7748
Practice Address - Country:US
Practice Address - Phone:406-543-7860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-29459225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist