Individual
GINA E LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
2905 CONNER LN, KISSIMMEE, FL 34741-7723
(321) 948-9907
Mailing address
2825 WAGON WHEEL TRL, SAINT CLOUD, FL 34772-8985
(321) 948-9907
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/13/2010
Last updated
08/13/2019
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