Individual
MARISSA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2131 S 157TH AVE, GOODYEAR, AZ 85338-3357
(623) 772-4600
Mailing address
13582 N 142ND DR, SURPRISE, AZ 85379-4954
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14755
AZ
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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