Individual
KEISY ARISLU LOPEZ-LOMELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
351 THORNTON RD STE 125, LITHIA SPRINGS, GA 30122-1589
(770) 577-0399
Mailing address
4575 DURON PL SW, MABLETON, GA 30126-1177
(712) 389-7919
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT006916
GA
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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