| NPI | 1215389283 |
|---|---|
| Former Name | MARIA MADELEINE LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.020659) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.015823) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2019-06-11 |