Individual
JENNISETH A LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2155 MAIN ST, SPRINGFIELD, MA 01104-3301
(413) 736-0395
Mailing address
2155 MAIN ST, SPRINGFIELD, MA 01104-3301
(413) 736-0395
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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