Provider Demographics
NPI:1962242164
Name:LOPEZ MORENO, ADRIANA K (BA SLT)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:K
Last Name:LOPEZ MORENO
Suffix:
Gender:F
Credentials:BA SLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 614
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-0614
Mailing Address - Country:US
Mailing Address - Phone:787-710-5857
Mailing Address - Fax:
Practice Address - Street 1:3B CALLE ABANICO
Practice Address - Street 2:URBANIZACION APONTE
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754
Practice Address - Country:US
Practice Address - Phone:787-202-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0076552355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant