| NPI | 1407507635 |
|---|---|
| Former Name | NICOLE LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 09885) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119008291) |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2025-02-04 |