Individual
SUSAN ELIZABETH LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMFT
Contact information
Practice address
817 COPPIN DR, FORT WORTH, TX 76120-2336
(469) 441-8707
Mailing address
817 COPPIN DR, FORT WORTH, TX 76120-2336
(469) 441-8707
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
65987
—
106H00000X
Marriage & Family Therapist
201385
TX
Other
Enumeration date
02/19/2012
Last updated
03/29/2021
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