Individual
MISS LAURA HOLLAND LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 W 23RD ST, YUMA, AZ 85364-6555
(928) 329-6035
Mailing address
107 W 23RD ST, YUMA, AZ 85364-6555
(928) 329-6035
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
336995
AZ
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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