Individual
MARISSA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
400 N HIGHLAND AVE, AURORA, IL 60506-3814
(630) 892-4355
Mailing address
400 N HIGHLAND AVE, AURORA, IL 60506-3814
(630) 892-4355
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
149.023176
IL
Other
Enumeration date
06/01/2021
Last updated
07/22/2021
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