Provider Demographics
NPI:1962020099
Name:BARREDA, MAYRA CRISTINA
Entity type:Individual
Prefix:MISS
First Name:MAYRA
Middle Name:CRISTINA
Last Name:BARREDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CEDAR BEND DR APT 1134
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5351
Mailing Address - Country:US
Mailing Address - Phone:915-494-3487
Mailing Address - Fax:
Practice Address - Street 1:2000 CEDAR BEND DR APT 1134
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5351
Practice Address - Country:US
Practice Address - Phone:915-494-3487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty