Individual
AMANDA MICHELLE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ASW #114024
Contact information
Practice address
23370 ROAD 22, CHOWCHILLA, CA 93610-8504
(559) 250-4461
Mailing address
2037 W BULLARD AVE # 121, FRESNO, CA 93711-1233
(559) 250-4461
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
114024
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
114024
CA
Other
Enumeration date
01/26/2023
Last updated
04/02/2024
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