Provider Demographics
NPI:1437032448
Name:LOPEZ, KIANI Y
Entity type:Individual
Prefix:
First Name:KIANI
Middle Name:Y
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. TOA ALTA HEIGHTS
Mailing Address - Street 2:K-33 CALLE 4
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-4200
Mailing Address - Country:US
Mailing Address - Phone:787-536-6186
Mailing Address - Fax:
Practice Address - Street 1:BO. ACHIOTE
Practice Address - Street 2:CARR. 164 KM. 6.2
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-909-4408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4636235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty