Individual
STEPHANIE MARIE LOPEZ RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10302 MOCKINGBIRD POND CT, BURKE, VA 22015-3715
(787) 307-0046
Mailing address
10302 MOCKINGBIRD POND CT, BURKE, VA 22015-3715
(787) 307-0046
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/19/2018
Last updated
08/19/2018
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