Individual
CICELY Y LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9114 MANGO AVE, MORTON GROVE, IL 60053-2544
(478) 338-4282
Mailing address
9114 MANGO AVE, MORTON GROVE, IL 60053-2544
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/21/2012
Last updated
03/16/2022
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