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Individual

IVYROSE MARIE LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPM

Contact information

Practice address
56 CONGER AVE, BURLINGTON, VT 05401-5234
(802) 310-8719
Mailing address
56 CONGER AVE, BURLINGTON, VT 05401-5234
(802) 310-8719

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary

Other

Enumeration date
06/24/2021
Last updated
06/24/2021
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