Healthcare Provider Details

I. General information

NPI: 1124814520
Provider Name (Legal Business Name): LIZBETH PAOLA LOPEZ GARCIA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 W 84TH DR
MERRILLVILLE IN
46410-6243
US

IV. Provider business mailing address

251 W 84TH DR
MERRILLVILLE IN
46410-6243
US

V. Phone/Fax

Practice location:
  • Phone: 219-282-3847
  • Fax:
Mailing address:
  • Phone: 219-282-3847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90957
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: