Individual
TARAH LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
120 NIX RIDGE RD, ASH FLAT, AR 72513-9017
(870) 994-3103
Mailing address
34 CHEYENNE DR, CHEROKEE VILLAGE, AR 72529-2117
(870) 847-5517
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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