Provider Demographics
NPI:1225419450
Name:LOPEZ, YELENNY (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:YELENNY
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 NW 29 CORT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-5043
Mailing Address - Country:US
Mailing Address - Phone:863-702-1107
Mailing Address - Fax:
Practice Address - Street 1:13 CALLE DUQUE DE KENT
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5322
Practice Address - Country:US
Practice Address - Phone:786-370-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-42455103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst