Individual
DR. NICOLE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1550 SW LOST TRAIL DR, PULLMAN, WA 99163-6002
(541) 521-4541
Mailing address
1550 SW LOST TRAIL DR, PULLMAN, WA 99163-6002
(541) 521-4541
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0002846
—
ID
Enumeration date
07/26/2019
Last updated
07/26/2019
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