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Individual

DAISY LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1841 PARK AVE, NEW YORK, NY 10035-1316
(646) 459-6091
Mailing address
3960 54TH ST APT 1N, WOODSIDE, NY 11377-4202
(917) 623-7640

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
13-3303089
NY
Enumeration date
03/26/2018
Last updated
10/26/2023
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