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General NPI Number Information
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NPI Number | 1174862882
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Entity Type | Individual
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Provider Name | REBECCA C VILLAR PSYD
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Gender | Female
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 1355 S INTERNATIONAL PKWY STE 2471
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City | LAKE MARY
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State | FL
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Zip | 32746-1694
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Country | US
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Telephone | 407-906-8843
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Fax | 888-335-7778
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Provider Business Mailing Address
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Address Line | 1355 S INTERNATIONAL PKWY STE 2471
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City | LAKE MARY
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State | FL
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Zip | 32746-1694
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Country | US
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Telephone | 407-906-8843
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Fax | 888-335-7778
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 8696
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY8696
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License Number State | FL
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