Provider Demographics
NPI:1134309545
Name:HERRERA, VICTORIA MARGARET (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:MARGARET
Last Name:HERRERA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 SARATOGA DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-1595
Mailing Address - Country:US
Mailing Address - Phone:505-892-6712
Mailing Address - Fax:505-892-5470
Practice Address - Street 1:1425 SARATOGA DR NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-1595
Practice Address - Country:US
Practice Address - Phone:505-892-6712
Practice Address - Fax:505-892-5470
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4246235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist