Individual
JOHANNA VELASCO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
PO BOX 16266, SAN LUIS, AZ 85349-6964
(928) 259-6982
Mailing address
PO BOX 16266, SAN LUIS, AZ 85349-6964
(928) 259-6982
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-050276
AZ
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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