Provider Demographics
NPI:1730324112
Name:PEREA, JESSENIA N (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JESSENIA
Middle Name:N
Last Name:PEREA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32211 SKY WAY LN
Mailing Address - Street 2:
Mailing Address - City:WALLER
Mailing Address - State:TX
Mailing Address - Zip Code:77484-9052
Mailing Address - Country:US
Mailing Address - Phone:832-388-8964
Mailing Address - Fax:832-998-8141
Practice Address - Street 1:32211 SKY WAY LN
Practice Address - Street 2:
Practice Address - City:WALLER
Practice Address - State:TX
Practice Address - Zip Code:77484-9052
Practice Address - Country:US
Practice Address - Phone:832-388-8964
Practice Address - Fax:832-998-8141
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist