| NPI | 1447014477 |
|---|---|
| Former Name | ALYCIA DOMENIQUE LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2024-02-09 |
| Last Update Date | 2025-08-07 |