Individual
MRS. KASSIDY RAE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1208 E 3300 S, MILLCREEK, UT 84106-2522
(801) 483-1600
(801) 483-1610
Mailing address
1208 E 3300 S, MILLCREEK, UT 84106-2522
(801) 483-1600
(801) 483-1610
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
122470653501
UT
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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