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General NPI Number Information
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NPI Number | 1841784956
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Entity Type | Individual
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Provider Name | JACQUELYNN MONIQUE BARRERA SLP-A; RBT
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Gender | Female
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 4242 WOODCOCK DR
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City | SAN ANTONIO
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State | TX
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Zip | 78228-1325
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Country | US
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Telephone | 210-435-1000
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Fax | 210-200-6056
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Provider Business Mailing Address
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Address Line | 4242 WOODCOCK DR
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City | SAN ANTONIO
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State | TX
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Zip | 78228-1325
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Country | US
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Telephone | 210-435-1000
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Fax | 210-200-6056
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 35453
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License Number State | TX
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