Provider Demographics
NPI:1124814520
Name:LOPEZ GARCIA, LIZBETH PAOLA (RBT)
Entity type:Individual
Prefix:
First Name:LIZBETH
Middle Name:PAOLA
Last Name:LOPEZ GARCIA
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8398 MISSISSIPPI ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6316
Mailing Address - Country:US
Mailing Address - Phone:219-755-4049
Mailing Address - Fax:
Practice Address - Street 1:8398 MISSISSIPPI ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6316
Practice Address - Country:US
Practice Address - Phone:219-755-4049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-21-165295106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician