Individual
KATRIEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4599
(208) 422-1000
Mailing address
712 W HAYS ST APT 2, BOISE, ID 83702-5556
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
TX
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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