| NPI | 1881726842 |
|---|---|
| Former Name | JEANETTE SUSAN LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 66090) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2018-05-23 |