Individual
DALLAS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
4000 SMITHTOWN RD STE 200, SUWANEE, GA 30024-6560
(470) 632-4990
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-207468
GA
Other
Enumeration date
03/16/2022
Last updated
03/16/2022
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