Healthcare Provider Details

I. General information

NPI: 1417872185
Provider Name (Legal Business Name): SAMANTHA LEE VILLENAUVE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 FARRAGUT RD
CINCINNATI OH
45218-1422
US

IV. Provider business mailing address

3310 CARDIFF AVE APT 213
CINCINNATI OH
45209-1381
US

V. Phone/Fax

Practice location:
  • Phone: 513-619-2490
  • Fax:
Mailing address:
  • Phone: 234-380-7955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.16145
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: