Individual
ANNA BARRAZA-DERDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
901 WALLACE BLVD, AMARILLO, TX 79106-1705
(806) 677-2126
(806) 359-0506
Mailing address
901 WALLACE BLVD, AMARILLO, TX 79106-1705
(806) 677-2126
(806) 359-0506
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
106277
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
05
—
207164901
—
TX
Enumeration date
08/31/2012
Last updated
09/15/2015
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