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General NPI Number Information
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NPI Number | 1083877153
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Entity Type | Individual
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Provider Name | REBECA LOPEZ MSSP
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Gender | Female
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | PROLONGACION 19 NE
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City | PUERTO NUEVO
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-449-0607
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 CALLE FRAY GRANADA EL SENORIAL
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City | SAN JUAN
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State | PR
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Zip | 00926-6942
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Country | US
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Telephone | 787-409-4226
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 308
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License Number State | PR
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