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General NPI Number Information
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NPI Number | 1215546239
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Entity Type | Individual
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Provider Name | KAYLEE LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 07/26/2020
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1225 CORPORATE DR
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City | HOLLAND
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State | OH
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Zip | 43528-7899
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Country | US
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Telephone | 419-866-0555
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Fax |
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Provider Business Mailing Address
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Address Line | 1069 REYNOLDS ST
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City | NAPOLEON
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State | OH
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Zip | 43545-1182
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT011462
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License Number State | OH
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