Provider Demographics
NPI:1659514453
Name:LOPEZ, BELINDA J (PHD)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:J
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5329 BONHAM ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-1914
Mailing Address - Country:US
Mailing Address - Phone:361-779-0771
Mailing Address - Fax:
Practice Address - Street 1:5329 BONHAM ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-1914
Practice Address - Country:US
Practice Address - Phone:361-779-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-09
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59804101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional