Provider Demographics
NPI:1316011224
Name:LOPEZ, YOLANDA T (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:T
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 18N4
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-9419
Mailing Address - Country:US
Mailing Address - Phone:956-781-2955
Mailing Address - Fax:956-781-6072
Practice Address - Street 1:RR 1 BOX 18N4
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-9419
Practice Address - Country:US
Practice Address - Phone:956-781-2955
Practice Address - Fax:956-781-6072
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09844171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator