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1053967893
LARYSSA CHARISSE LOPEZ
MELBOURNE, FL
NPI
1053967893
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: FL RBT-19-95786)
Enumeration Date
2019-08-16
Last Update Date
2019-12-19
Business Address
LARYSSA CHARISSE LOPEZ RBT
125 E NASA BLVD
MELBOURNE, FL 32901-1900
Phone number: 321-372-6813
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Mailing Address
LARYSSA CHARISSE LOPEZ RBT
125 E NASA BLVD
MELBOURNE, FL 32901-1900
Phone number: 321-372-6813
Copy
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