Provider Demographics
NPI:1306623871
Name:HERRERA, STEPHANIE MEJIAS (SLPA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MEJIAS
Last Name:HERRERA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W HIDDEN VALLEY BLVD APT 104
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1578
Mailing Address - Country:US
Mailing Address - Phone:562-787-3237
Mailing Address - Fax:
Practice Address - Street 1:100 W HIDDEN VALLEY BLVD APT 104
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1578
Practice Address - Country:US
Practice Address - Phone:561-376-2573
Practice Address - Fax:561-218-4939
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI33532355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant