Individual
CANDANCE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1401 UNIVERSAL CITY BLVD, UNIVERSAL CITY, TX 78148-3317
(210) 336-1524
Mailing address
1401 UNIVERSAL CITY BLVD, UNIVERSAL CITY, TX 78148-3317
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-65521
TX
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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