IVAN RICARDO LOPEZ

BRISTOL, FL
NPI1164058756
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: FL  16852)
Enumeration Date2020-03-16
Last Update Date2020-03-16
Business Address
IVAN RICARDO LOPEZ LCSW
11033 NW STATE ROAD 20
BRISTOL, FL 32321-6406
Phone number: 850-643-1155
Mailing Address
IVAN RICARDO LOPEZ LCSW
5001 LAKE FRONT DR APT B1
TALLAHASSEE, FL 32303-7171
Phone number: 863-216-9151
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