Individual
ALEXANDRA LOPEZ-FULGHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1061 VIRGINIA ST, DUNEDIN, FL 34698-7326
(727) 733-4189
Mailing address
10827 VENICE CIR, TAMPA, FL 33635-9501
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA8214
FL
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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