Provider Demographics
NPI:1588099311
Name:LOPEZ, ALANA DELORES (PHD)
Entity type:Individual
Prefix:DR
First Name:ALANA
Middle Name:DELORES
Last Name:LOPEZ
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 1:1611 SOUTH GREEN ROAD, SUITE 035
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3404
Mailing Address - Country:US
Mailing Address - Phone:216-716-7818
Mailing Address - Fax:216-716-7918
Practice Address - Street 1:1611 S GREEN RD STE 35
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4128
Practice Address - Country:US
Practice Address - Phone:216-716-7818
Practice Address - Fax:216-716-7918
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7017103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent