Individual
BENJAMIN D LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3048 S CLIFTON AVE, SPRINGFIELD, MO 65807-5957
(417) 818-5784
Mailing address
1032 E COMMERCIAL ST, SPRINGFIELD, MO 65803-3230
(214) 693-2775
(214) 693-2775
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB970773
MO
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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