Provider Demographics
NPI:1841784956
Name:BARRERA, JACQUELYNN MONIQUE (SLP-A; RBT)
Entity Type:Individual
Prefix:
First Name:JACQUELYNN
Middle Name:MONIQUE
Last Name:BARRERA
Suffix:
Gender:F
Credentials:SLP-A; RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 WOODCOCK DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1325
Mailing Address - Country:US
Mailing Address - Phone:210-435-1000
Mailing Address - Fax:210-200-6056
Practice Address - Street 1:4242 WOODCOCK DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1325
Practice Address - Country:US
Practice Address - Phone:210-435-1000
Practice Address - Fax:210-200-6056
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX354532355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant