Individual
ROCIO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
433 PARK ST, HAZELTON, ID 83335
(208) 490-1410
Mailing address
PO BOX 404, HAZELTON, ID 83335-0404
(208) 490-1410
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
VG478686E
ID
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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