Individual
STACEY ROBIN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
465 GRAND ST, HAND IN HAND DEVELOPMENT,, NEW YORK, NY 10002-4800
(212) 420-1999
Mailing address
415 GRAND ST, APT# E1104, NEW YORK, NY 10002-4772
(212) 673-4868
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/12/2011
Last updated
06/20/2012
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