Individual
BENJAMIN LOPEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4764 VERO BEACH PL, KISSIMMEE, FL 34746-7412
(787) 460-1798
Mailing address
4764 VERO BEACH PL, KISSIMMEE, FL 34746-7412
(787) 460-1798
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
19176
PR
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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