Individual
JESSICA CAROLINA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 WALNUT ST STE 200, WELLESLEY, MA 02481-2101
(781) 943-3696
Mailing address
35 WALNUT ST STE 200, WELLESLEY, MA 02481-2101
(781) 943-3696
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MA
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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