Provider Demographics
NPI:1285899591
Name:BARRERA, GEORGINA (SLP)
Entity type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:BARRERA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2267 TRAWOOD DR STE G3
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3027
Mailing Address - Country:US
Mailing Address - Phone:915-307-9289
Mailing Address - Fax:512-858-9582
Practice Address - Street 1:2267 TRAWOOD DR STE G3
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3027
Practice Address - Country:US
Practice Address - Phone:915-307-9289
Practice Address - Fax:915-975-8168
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16950235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist