Individual
RAUL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
464 COMMON ST, BELMONT, MA 02478-2704
(339) 225-5412
Mailing address
464 COMMON ST, BELMONT, MA 02478-2704
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31931
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-18-31931
BCBA#
MA
Enumeration date
11/13/2018
Last updated
11/13/2018
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