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Individual

MRS. JESSICA DIANE LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
19590 E MAINSTREET STE 202, PARKER, CO 80138-7371
(505) 710-3060
Mailing address
17288 E TRAILMASTER DR, PARKER, CO 80134-4354
(505) 710-3060

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
B-07662
NM
104100000X
Social Worker
Primary
CSW.09926272
CO

Other

Enumeration date
09/18/2014
Last updated
02/07/2020
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