Individual
MRS. ELVIRA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
7759 WESTWOOD ST, DETROIT, MI 48228-3341
(313) 271-1944
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801085539
MI
Other
Enumeration date
04/15/2009
Last updated
04/15/2009
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