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Individual
THEODORE IAN LOPEZ
Active
Individual
THEODORE IAN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
ASW68504
CA
1041C0700X
Clinical Social Worker
Primary
LCSW88983
CA
Other
Enumeration date
10/26/2015
Last updated
09/22/2021
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