Individual
JESSICA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1552
(203) 232-4051
Mailing address
35 RUTH ST APT 46, BRISTOL, CT 06010-3218
(787) 201-3793
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12415
CT
Other
Enumeration date
04/28/2023
Last updated
04/28/2023
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