Individual
JENNIFER LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
900 JUNCTION DR, ALLEN, TX 75013-5290
(469) 675-3153
Mailing address
149 PRINCETON XRDS APT 2301, PRINCETON, TX 75407-1560
(956) 518-9126
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
123538
TX
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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