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NPI Code Detail

MEDICARE: KATELYN LOPEZ LMFT

MEDICARE: KATELYN LOPEZ LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist4192NV

General Provider Information

NPI Number : 1083987531
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN LOPEZ LMFT
Provider Business Mailing Address
First Line : 5412 BOULDER HWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-6039
Country : US
Telephone Number : 702-291-7121
Fax Number :
Provider Business Practice Location Address
First Line : 5412 BOULDER HWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-6039
Country : US
Telephone Number : 702-291-7121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2012
Last Update Date : 10/19/2021

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Directions to “ KATELYN LOPEZ LMFT” Practice Location

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