Provider Demographics
NPI:1588373534
Name:LERMA, ANDREA RENEE (MS,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:RENEE
Last Name:LERMA
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TRINITY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-5114
Mailing Address - Country:US
Mailing Address - Phone:619-952-6148
Mailing Address - Fax:
Practice Address - Street 1:400 TRINITY VIEW RD
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76087-5114
Practice Address - Country:US
Practice Address - Phone:619-952-6148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117888235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist