Provider Demographics
NPI:1467948265
Name:LOPEZ, VANESSA LYNN (MS, SLP)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LYNN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 N JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6100
Mailing Address - Country:US
Mailing Address - Phone:956-631-3050
Mailing Address - Fax:956-630-4209
Practice Address - Street 1:702 N ED CAREY DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7914
Practice Address - Country:US
Practice Address - Phone:956-440-1155
Practice Address - Fax:956-440-0913
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113766235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist