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NPI Code Detail

MEDICARE: YESSICA VILLANUEVA GUERRA MA, CF-SLP

MEDICARE: YESSICA VILLANUEVA GUERRA MA, CF-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1265114458
Entity Type Code : Individual
Provider Name (Legal Business Name) : YESSICA VILLANUEVA GUERRA MA, CF-SLP
Provider Business Mailing Address
First Line : 7861 SANDY SPRINGS PT
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-4081
Country : US
Telephone Number : 910-644-3835
Fax Number :
Provider Business Practice Location Address
First Line : 2776 JANITELL RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-4103
Country : US
Telephone Number : 719-332-4689
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2023
Last Update Date : 08/07/2023

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