Provider Demographics
NPI:1194936914
Name:LOPEZ, ROBERT ALEXANDER (MFFTT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALEXANDER
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:MFFTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 W 54TH TER
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2416
Mailing Address - Country:US
Mailing Address - Phone:816-456-1674
Mailing Address - Fax:
Practice Address - Street 1:4101 W 54TH TER
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66205-2416
Practice Address - Country:US
Practice Address - Phone:816-456-1674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist