Individual
AMANDA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
65 JOHNSON AVE, RONKONKOMA, NY 11779-5374
(516) 983-2399
Mailing address
65 JOHNSON AVE, RONKONKOMA, NY 11779-5374
(516) 983-2399
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
101086-01
NY
Other
Enumeration date
11/05/2025
Last updated
11/05/2025
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