MEDICARE: DR. AMY BERGLUND-BARRAZA PHD, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	111829	TX

General Provider Information

NPI Number	:	1942913389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY BERGLUND-BARRAZA PHD, CCC-SLP

Provider Business Mailing Address
First Line	:	12247 RIDGEFAIR PL
Second Line	:
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75234-7805
Country	:	US
Telephone Number	:	208-596-2666
Fax Number	:

Provider Business Practice Location Address
First Line	:	12247 RIDGEFAIR PL
Second Line	:
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75234-7805
Country	:	US
Telephone Number	:	208-596-2666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2022
Last Update Date	:	12/30/2022

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Directions to “ DR. AMY BERGLUND-BARRAZA PHD, CCC-SLP” Practice Location

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