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General NPI Number Information
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NPI Number | 1275776064
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Entity Type | Individual
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Provider Name | INGRID VIRGINIA LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 7575 W FLAGLER ST STE 200
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City | MIAMI
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State | FL
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Zip | 33144-2467
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Country | US
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Telephone | 305-377-3297
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Fax |
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Provider Business Mailing Address
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Address Line | 500 BAYVIEW DR APT 1821
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-4779
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Country | US
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Telephone | 786-709-8397
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-15-06679
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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