Individual
MS. JENNIFER LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10114 WINSFORD OAK BLVD APT 511, TAMPA, FL 33624-5164
(352) 875-2494
Mailing address
10114 WINSFORD OAK BLVD APT 511, TAMPA, FL 33624-5164
(352) 875-2494
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
FL
2355S0801X
Speech-Language Assistant
Primary
SI2022
FL
Other
Enumeration date
07/31/2018
Last updated
03/07/2019
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