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Individual

AMANDA MERCEDES LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1555 W 44TH PL APT 259, HIALEAH, FL 33012-7840
(786) 546-3668
Mailing address
1555 W 44TH PL APT 259, HIALEAH, FL 33012-7840

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA15761
FL

Other

Enumeration date
03/17/2017
Last updated
03/17/2017
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