Individual
JENNIFER ANN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4510 SALT LAKE BLVD, HONOLULU, HI 96818-3153
(562) 639-3341
Mailing address
1441 UILA ST, HONOLULU, HI 96818-1941
(562) 639-3341
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
HI
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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