Provider Demographics
NPI:1598987760
Name:GUERRA, ANA M (SLP-CCC)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:M
Last Name:GUERRA
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1050
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-1050
Mailing Address - Country:US
Mailing Address - Phone:956-765-1999
Mailing Address - Fax:956-765-1998
Practice Address - Street 1:1513 JACKSON ST
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3572
Practice Address - Country:US
Practice Address - Phone:956-765-1999
Practice Address - Fax:956-765-1998
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX264128855Medicaid