Provider Demographics
NPI:1891195921
Name:VEGA BARRETO, NEYSA (PHL)
Entity type:Individual
Prefix:
First Name:NEYSA
Middle Name:
Last Name:VEGA BARRETO
Suffix:
Gender:
Credentials:PHL
Other - Prefix:
Other - First Name:NEYSA
Other - Middle Name:
Other - Last Name:VEGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHL
Mailing Address - Street 1:CARR 2 KM 95 H0 BO YEGUADA
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627
Mailing Address - Country:US
Mailing Address - Phone:787-680-4659
Mailing Address - Fax:
Practice Address - Street 1:6601 MONTANA AVE STE G&H
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-2155
Practice Address - Country:US
Practice Address - Phone:915-838-7604
Practice Address - Fax:915-772-4633
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist