Individual
JAZMYN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S
Contact information
Practice address
2515 N CLARK ST, CHICAGO, IL 60614-2730
(312) 227-6322
Mailing address
3702 N RICHMOND ST, CHICAGO, IL 60618-3525
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.015002
IL
235Z00000X
Speech-Language Pathologist
242.005136
IL
Other
Enumeration date
09/21/2018
Last updated
08/19/2019
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