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General NPI Number Information
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NPI Number | 1306239553
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Entity Type | Organization
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Legal Business Name | VILLAR NEUROPSYCHOLOGY, LLC
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 03/12/2015
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Provider Practice Location Address
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Address Line | 1301 S INTERNATIONAL PKWY SUITE 2021
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City | LAKE MARY
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State | FL
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Zip | 32746-1409
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Country | US
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Telephone | 407-906-8843
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 941652
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City | MAITLAND
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State | FL
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Zip | 32794-1652
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NEUROPSYCHOLOGIST
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Name | DR. REBECCA C. VILLAR
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Credential | PSYD
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Telephone | 407-906-8843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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