Individual
MICHELLE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2415 GRESHAM DR, ORLANDO, FL 32807-6409
(407) 595-6215
Mailing address
2415 GRESHAM DR, ORLANDO, FL 32807-6409
(407) 595-6215
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA13400
FL
224Z00000X
Occupational Therapy Assistant
—
—
251V00000X
Voluntary or Charitable Agency
Primary
OTA13400
FL
Other
Enumeration date
01/24/2016
Last updated
09/21/2020
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