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Individual

SUSAN MARIE LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
10530 SPOTSYLVANIA AVE, CHILDREN'S HOSPITAL THERAPY CENTER SUITE 102, FREDERICKSBURG, VA 22408-0000
(540) 891-4485
(540) 890-4486
Mailing address
2924 BROOK RD, CHILDREN'S HOSPITAL CREDENTIALING DEPT, RICHMOND, VA 23220-1215
(804) 321-7474
(804) 321-2728

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
2201000442
VA
235Z00000X
Speech-Language Pathologist
Primary
2202001904
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004909976
VA
Enumeration date
02/15/2007
Last updated
09/17/2025
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