Individual
TATIANA MARIE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
4554 E INVERNESS AVE STE C1, MESA, AZ 85206-4639
(480) 295-4925
Mailing address
7126 N 19TH AVE UNIT 124, PHOENIX, AZ 85021-8523
(713) 791-2833
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH009618
AZ
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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