Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00398300 | NJ |
NPI | 1114313509 |
---|---|
Provider Name | Ms. Maritess Lopez |
First Address | Lambertville, NJ 08530-1800 |
Second Address | Lambertville, NJ 08530-1800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 13/04/2015 |