Individual
TARA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6774 W AURORA DR, GLENDALE, AZ 85308-8958
(623) 975-4578
Mailing address
6774 W AURORA DR, GLENDALE, AZ 85308-8958
(623) 975-4578
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA8593
AZ
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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