Individual
GIANEXIS ALTAGRACIA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1495 N PARK DR, WESTON, FL 33326-3215
(954) 356-2878
Mailing address
816 NW 208TH CIR, PEMBROKE PINES, FL 33029-1909
(201) 709-4304
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI2740
FL
Other
Enumeration date
11/13/2018
Last updated
11/13/2018
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