Healthcare Provider Details

I. General information

NPI: 1922445543
Provider Name (Legal Business Name): BELEN LOPEZ-ADDISON SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BELEN LOPEZ

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 HOUMA BLVD STE 108
METAIRIE LA
70006-2930
US

IV. Provider business mailing address

3901 HOUMA BLVD STE 108
METAIRIE LA
70006-2930
US

V. Phone/Fax

Practice location:
  • Phone: 504-784-8840
  • Fax: 504-218-5317
Mailing address:
  • Phone: 504-784-8840
  • Fax: 504-218-5317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberC-5523
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7622
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7612
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: