Individual
JAVIER LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
9209 WABADAY AVE, OVERLAND, MO 63114-5527
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2008000928
MO
Other
Enumeration date
08/05/2006
Last updated
01/30/2008
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