Individual
BRENDA SARAI LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 TRINITY VIEW ST, IRVING, TX 75060-6248
(214) 930-1434
Mailing address
2104 GREENBRIAR DR, SOUTHLAKE, TX 76092-8355
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-96708
TX
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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