Provider Demographics
NPI:1407626625
Name:BARRERA, LORISSA (SLP)
Entity Type:Individual
Prefix:
First Name:LORISSA
Middle Name:
Last Name:BARRERA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3713 AMANDA LN
Mailing Address - Street 2:
Mailing Address - City:ROBSTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78380-2026
Mailing Address - Country:US
Mailing Address - Phone:361-227-1064
Mailing Address - Fax:
Practice Address - Street 1:3713 AMANDA LN
Practice Address - Street 2:
Practice Address - City:ROBSTOWN
Practice Address - State:TX
Practice Address - Zip Code:78380-2026
Practice Address - Country:US
Practice Address - Phone:361-227-1064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113577235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist