Provider Demographics
NPI:1528224466
Name:LOPEZ, ALEXSANDRA (BILINGUAL CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALEXSANDRA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:BILINGUAL CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 SAINT LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-1360
Mailing Address - Country:US
Mailing Address - Phone:716-863-4807
Mailing Address - Fax:
Practice Address - Street 1:605 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1044
Practice Address - Country:US
Practice Address - Phone:716-863-4807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016077235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist