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Individual

LORRAINE TAVAREZ LOPEZ

Active
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Individual

LORRAINE TAVAREZ LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPES

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
4657
SC
103TS0200X
School Psychologist
4657
SC
252Y00000X
Early Intervention Provider Agency
Primary
—
NULL

Other

Enumeration date
12/22/2015
Last updated
06/08/2024
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