Individual
MRS. JOYCE M LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBA
Contact information
Practice address
16632 S 29TH PL, PHOENIX, AZ 85048-8518
(480) 940-0938
Mailing address
16632 S 29TH PL, PHOENIX, AZ 85048-8518
(480) 940-0938
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
10719
AZ
Other
Enumeration date
08/09/2007
Last updated
08/09/2007
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