Provider Demographics
NPI:1033668447
Name:MONTES DE OCA LOPEZ, LUCERO
Entity Type:Individual
Prefix:MISS
First Name:LUCERO
Middle Name:
Last Name:MONTES DE OCA LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LUCERO
Other - Middle Name:
Other - Last Name:MONTES DE OCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9480 S EASTERN AVE STE 273
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-8000
Mailing Address - Country:US
Mailing Address - Phone:702-610-6653
Mailing Address - Fax:
Practice Address - Street 1:9480 S EASTERN AVE STE 273
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-8000
Practice Address - Country:US
Practice Address - Phone:702-355-9862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-16-23574106S00000X
NVSP-3764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician