Provider Demographics
NPI:1184757478
Name:HERRERA, HEATHER RENEE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENEE
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3853 WILLOW GLEN DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3634
Mailing Address - Country:US
Mailing Address - Phone:575-496-9279
Mailing Address - Fax:
Practice Address - Street 1:3853 WILLOW GLEN DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3634
Practice Address - Country:US
Practice Address - Phone:575-496-9279
Practice Address - Fax:575-993-5020
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM40722355S0801X
NM4784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant