Provider Demographics
NPI:1770905028
Name:LOPEZ, DESTINEE DAYE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:DESTINEE
Middle Name:DAYE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:DESTINEE
Other - Middle Name:DAYE
Other - Last Name:HEDSPETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:21627 GANNET PEAK WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-0138
Mailing Address - Country:US
Mailing Address - Phone:281-235-2797
Mailing Address - Fax:
Practice Address - Street 1:24530 KINGSLAND BLVD # B
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3429
Practice Address - Country:US
Practice Address - Phone:281-235-2797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108883235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist