Individual
JAQUELINE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
889 N MAIZE RD STE 200, WICHITA, KS 67212-4559
(316) 518-0381
Mailing address
825 N WACO AVE STE 200, WICHITA, KS 67203-3939
(316) 201-6047
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
03217-T
KS
106H00000X
Marriage & Family Therapist
Primary
03229
KS
Other
Enumeration date
12/16/2020
Last updated
07/10/2025
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