Provider Demographics
NPI:1295287209
Name:LOPEZ-ALERS, MARIA DE LOURDES (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIA DE LOURDES
Middle Name:
Last Name:LOPEZ-ALERS
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 1:113 URB MONTEMAR
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-3034
Mailing Address - Country:US
Mailing Address - Phone:939-339-1353
Mailing Address - Fax:
Practice Address - Street 1:2625 PR 2
Practice Address - Street 2:SUITE 2
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:939-339-1353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5682103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical