Individual
SHONTEL M LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5800 PRESTON OAKS RD APT 1027, DALLAS, TX 75254-8707
(575) 571-1673
Mailing address
PO BOX 803703, DALLAS, TX 75380-3703
(575) 571-1673
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215990
TX
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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