| NPI | 1104470830 |
|---|---|
| Former Name | JESSICA LYNN LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 027256) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 21512) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2025-03-28 |