Provider Demographics
NPI:1154055804
Name:LOPEZ, JENNIFER ODALYS (SLP-ASSISTANT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ODALYS
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:SLP-ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9603 HEIDELBERG CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-2071
Mailing Address - Country:US
Mailing Address - Phone:713-834-5276
Mailing Address - Fax:
Practice Address - Street 1:9603 HEIDELBERG CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-2071
Practice Address - Country:US
Practice Address - Phone:713-834-5276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-10
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX425092355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant