Healthcare Provider Details

I. General information

NPI: 1023707601
Provider Name (Legal Business Name): BRYSSA ANNE MARIE TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 CLEVELAND HEIGHTS RD NE
RIO RANCHO NM
87144-1607
US

IV. Provider business mailing address

155 BECKY CT
BOSQUE FARMS NM
87068-9599
US

V. Phone/Fax

Practice location:
  • Phone: 505-896-0667
  • Fax:
Mailing address:
  • Phone: 575-915-6823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2026-0287
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: