Provider Demographics
NPI:1679125090
Name:LOPEZ, EMILY MARIE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MARIE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:MARIE
Other - Last Name:FROEMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2262 EMERALD LN
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-3042
Mailing Address - Country:US
Mailing Address - Phone:815-274-9448
Mailing Address - Fax:
Practice Address - Street 1:3S140 BARKLEY AVE
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-1505
Practice Address - Country:US
Practice Address - Phone:630-425-3183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst