Individual
LIANE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 VETERANS PKWY, NEW LENOX, IL 60451-2899
(815) 717-1700
Mailing address
301 VETERANS PKWY, NEW LENOX, IL 60451-2899
(815) 717-1700
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010434
IL
103TC1900X
Counseling Psychologist
2013-61
KY
Other
Enumeration date
07/31/2013
Last updated
05/13/2021
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