Individual
KASANDRA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1213 CREASE ST APT B, PHILADELPHIA, PA 19125-3901
(484) 447-0337
Mailing address
1213 CREASE ST APT B, PHILADELPHIA, PA 19125-3901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/17/2022
Last updated
04/17/2022
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