Provider Demographics
NPI:1811412364
Name:LOPEZ, CAROLINE (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:MISS
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:SINICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED
Mailing Address - Street 1:5 JULIA PL
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-2461
Mailing Address - Country:US
Mailing Address - Phone:413-347-0067
Mailing Address - Fax:
Practice Address - Street 1:55 MADISON AVE STE 400
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7397
Practice Address - Country:US
Practice Address - Phone:201-787-6786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-06
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00985500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist