Individual
DR. MARY BETH LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
6331 SW 41ST CT, DAVIE, FL 33314-3405
(954) 533-9019
(954) 530-2054
Mailing address
3092 NW 127TH TER, SUNRISE, FL 33323-6343
(954) 533-9019
(954) 530-2054
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
PY 7941
FL
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Enumeration date
06/04/2007
Last updated
01/22/2014
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