Individual
LIZETH MAHALALEEL LOPEZ GASTELUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENCIADO
Contact information
Practice address
16485 N STADIUM WAY UNIT 1091, SURPRISE, AZ 85374-4380
(510) 807-8567
Mailing address
254 E 2ND ST PMB87 356, CALEXICO, CA 92231
(510) 807-8567
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
25-439749
CA
Other
Enumeration date
06/01/2026
Last updated
06/01/2026
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