Individual
LIDIA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1017 W ELNA RAE ST, TEMPE, AZ 85281-5337
(928) 581-4490
Mailing address
1017 W ELNA RAE ST, TEMPE, AZ 85281-5337
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6811
AZ
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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