Provider Demographics
NPI:1760271951
Name:HERRERA, MARIA DELORES
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:DELORES
Last Name:HERRERA
Suffix:
Gender:
Credentials:
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:DELORES
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7602 3RD WAY SE APT 11
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1504
Mailing Address - Country:US
Mailing Address - Phone:360-706-3259
Mailing Address - Fax:
Practice Address - Street 1:7602 3RD WAY SE APT 11
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1504
Practice Address - Country:US
Practice Address - Phone:360-706-3259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician