Individual
ESMERALDA REYES LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
912 NE KELLY AVE # 100C, GRESHAM, OR 97030-5629
(503) 912-5502
Mailing address
2905 SE PALMQUIST RD UNIT 28, GRESHAM, OR 97080-5357
(971) 772-8485
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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