Provider Demographics
NPI:1932990132
Name:VILLEGAS, PRISCILLA MICHELLE
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:MICHELLE
Last Name:VILLEGAS
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 1:9936 NW 47TH TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1939
Mailing Address - Country:US
Mailing Address - Phone:786-212-7790
Mailing Address - Fax:
Practice Address - Street 1:6191 ORANGE DR STE 6167
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-3454
Practice Address - Country:US
Practice Address - Phone:954-800-4078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI78892355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant