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General NPI Number Information
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NPI Number | 1942570882
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Entity Type | Individual
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Provider Name | RUTH JOHANNA LOPEZ LIC.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 05/25/2018
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Provider Practice Location Address
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Address Line | URB. SABANERA DORADO # 484 CAMINO EL YUNQUE
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-960-4748
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Fax | 787-796-8529
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Provider Business Mailing Address
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Address Line | URB. SABANERA DORADO # 484 CAMINO EL YUNQUE
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City | DORADO
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State | PR
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Zip | 00646-3640
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Country | US
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Telephone | 787-960-4748
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Fax | 787-946-4414
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 4134
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License Number State | PR
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