Individual
MALYSSA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
236 2ND AVE, NEW YORK, NY 10003-2704
(212) 683-8905
(212) 683-8906
Mailing address
236 2ND AVE, NEW YORK, NY 10003-2704
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008836-1
NY
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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