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Individual

SAMANTHA LEE LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
47 PARK PL STE 200H, APPLETON, WI 54914-8210
(715) 848-5022
(888) 778-6750
Mailing address
N1350 TUCKAWAY CT, GREENVILLE, WI 54942-8045
(715) 301-0014
(888) 778-6750

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
104940
NY
104100000X
Social Worker
Primary
12932
WI

Other

Enumeration date
04/16/2019
Last updated
06/01/2026
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