Individual
MISS JACQUELINE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
4220 80TH ST NE, MARYSVILLE, WA 98270-3423
(360) 657-6415
Mailing address
8825 34TH AVE NE STE L, QUIL CEDA VILLAGE, WA 98271-8085
(360) 965-0751
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003404
WA
Other
Enumeration date
10/04/2013
Last updated
03/10/2024
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