Individual
COURTNEY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
850 12TH AVE, FORT WORTH, TX 76104-2516
(337) 414-0060
Mailing address
504 ASTOR PLACE DR, NEW IBERIA, LA 70563-2232
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
114125
TX
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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