Individual
ILORIA VICTORIA PHOENIX LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1801 HICKMAN RD, DES MOINES, IA 50314-1548
(515) 282-5695
Mailing address
1801 23RD ST, DES MOINES, IA 50310-6022
(336) 987-6782
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0084
IA
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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