Individual
PATRICIA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
10140 DEER RUN FRM RD, FORT MYERS, FL 33966-1045
(239) 791-1586
Mailing address
3763 EVANS AVE, FORT MYERS, FL 33901-9302
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103TS0200X
School Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/16/2013
Last updated
03/13/2014
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