Individual
MARISSA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
405 W 6TH ST, SILVER CITY, NM 88061-5010
(575) 956-2150
Mailing address
2810 N SWAN ST, SILVER CITY, NM 88061-5853
(575) 956-2000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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