Provider Demographics
NPI:1831223809
Name:CONTRERAS, VANESSA RENEE (MS,SLP-CCC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:RENEE
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:MS,SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16815 ROYAL CREST DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2521
Mailing Address - Country:US
Mailing Address - Phone:281-488-4431
Mailing Address - Fax:281-488-1213
Practice Address - Street 1:16815 ROYAL CREST DR
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2521
Practice Address - Country:US
Practice Address - Phone:281-488-4431
Practice Address - Fax:281-488-1213
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101229235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87744TOtherBLUECROSSBLUESHIELD ID