Individual
ANDREA CAROLINE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSP, NCSP
Contact information
Practice address
4505 W DEYOUNG ST STE 203C, MARION, IL 62959-5899
(618) 283-2222
Mailing address
1089 BOSKYDELL RD APT 23, CARBONDALE, IL 62902-6107
(618) 571-1566
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2557889
IL
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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