Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 34340 | TX |
Y | 103TH0004X | Health Psychologist | 34340 | TX |
NPI | 1629605936 |
---|---|
Provider Name | Dr. Rebecca Lopez |
First Address | Houston, TX 77079-2119 |
Second Address | Houston, TX 77079-2119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2020 |
Last Update Date | 19/05/2021 |