Individual
MARISOL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13922 CERISE AVE, HAWTHORNE, CA 90250-8688
(310) 679-4994
Mailing address
13922 CERISE AVE, HAWTHORNE, CA 90250-8688
(310) 679-4994
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2770
CA
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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