Individual
MS. TANYA L LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN
Contact information
Practice address
803 GRANT AVE, LAKE KATRINE, NY 12449-5352
(845) 331-5064
Mailing address
803 GRANT AVE, LAKE KATRINE, NY 12449-5352
(845) 331-5064
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1082745
NY
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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