Provider Demographics
NPI:1881960664
Name:LOPEZ REYES, CLAUDIA VALENTINA (BCBA)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:VALENTINA
Last Name:LOPEZ REYES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 NW 77TH ST
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2214
Mailing Address - Country:US
Mailing Address - Phone:786-499-2615
Mailing Address - Fax:305-846-9711
Practice Address - Street 1:885 WOODSTOCK RD STE 430-226
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2277
Practice Address - Country:US
Practice Address - Phone:404-641-4024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
1-17-26268103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst