Individual
TIFFANY LORRAINE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
581 MAIN ST, SUITE 640, WOODBRIDGE, NJ 07095-1148
(732) 204-1635
Mailing address
17435 US HIGHWAY 441 STE 101, MOUNT DORA, FL 32757-6750
(352) 434-0455
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/05/2015
Last updated
01/16/2019
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