Doctor Name: | SUSAN MARIE LOPEZ |
NPI Number: | 1265575278 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 2202001904 |
Business Practice Address: | 10530 Spotsylvania Ave Children's Hospital Therapy Center Suite 102 Fredericksburg, VA - 224080000 |
Business Phone Number: | 5408914485 |
Business Fax Number: | 5408904486 |
Mailing Address: | 2924 Brook Rd, Children's Hospital Credentialing Dept RICHMOND |
State: | VA |
Postal Code: | 232201215 |
Phone Number: | 8043217474 |
Fax Number: | 8043212728 |
NPI Enumeration Date: | 02/15/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202001904 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |