Individual
JENNIFER LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
4215 AVENUE I, SCOTTSBLUFF, NE 69361-4902
(308) 635-3696
Mailing address
2304 TORBEN CT, CHEYENNE, WY 82009-9833
(307) 575-9702
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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