Provider Demographics
NPI:1740929884
Name:LOPEZ, CAITLIN R (RBT)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:R
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8731 SUMMIT PINES DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2307
Mailing Address - Country:US
Mailing Address - Phone:406-930-6114
Mailing Address - Fax:
Practice Address - Street 1:18401 TIMBER FOREST DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2535
Practice Address - Country:US
Practice Address - Phone:406-390-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician