Healthcare Provider Details

I. General information

NPI: 1033022041
Provider Name (Legal Business Name): VALERIA HIDALGO LOPEZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 7TH ST FL 3
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

8910 PURDUE RD STE 700
INDIANAPOLIS IN
46268-6136
US

V. Phone/Fax

Practice location:
  • Phone: 800-603-6046
  • Fax: 317-884-3393
Mailing address:
  • Phone: 800-603-6046
  • Fax: 317-884-3393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12156
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: