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Individual
MAYRA GRICEL LOPEZ
Active
Individual
MAYRA GRICEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
73702
CA
1041C0700X
Clinical Social Worker
Primary
91999
CA
Other
Enumeration date
01/10/2017
Last updated
10/02/2019
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