Individual
MAKENZIE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2325 S HARVARD AVE, TULSA, OK 74114-3300
(918) 712-4301
Mailing address
19806 E 38TH ST S, BROKEN ARROW, OK 74014-1227
(539) 292-8485
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200669990B
—
OK
Enumeration date
09/23/2016
Last updated
03/17/2022
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