Individual
HEATHER SHAE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
137 UPLAND WAY # 25, RESACA, GA 30735-6186
(706) 229-1742
Mailing address
137 UPLAND WAY # 25, RESACA, GA 30735-6186
(706) 229-1742
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-1
—
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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