Individual
MRS. EVELYN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ITDS-PROVIDER
Contact information
Practice address
19634 BLACK OLIVE LN, BOCA RATON, FL 33498-4828
(561) 477-5832
Mailing address
19634 BLACK OLIVE LN, BOCA RATON, FL 33498-4828
(561) 477-5832
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811788800
—
FL
Enumeration date
04/26/2007
Last updated
12/26/2018
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