Provider Demographics
NPI:1730868373
Name:LOPEZ OLMO, VALERIA MICHELLE (MS)
Entity type:Individual
Prefix:
First Name:VALERIA
Middle Name:MICHELLE
Last Name:LOPEZ OLMO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:D4202 CONDOMINIO COSTA ESMERALDA
Mailing Address - Street 2:
Mailing Address - City:CEIBA
Mailing Address - State:PR
Mailing Address - Zip Code:00735-9998
Mailing Address - Country:US
Mailing Address - Phone:787-455-7741
Mailing Address - Fax:
Practice Address - Street 1:CARR. 191 KM 1.1 PALMER GALATEO
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-455-7741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7706103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling