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General NPI Number Information
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NPI Number | 1457172736
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Entity Type | Individual
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Provider Name | JENIFFER LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 3124 CENTER POINT DR
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City | EDINBURG
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State | TX
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Zip | 78539-4804
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Country | US
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Telephone | 956-694-1565
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Fax |
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Provider Business Mailing Address
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Address Line | 807 ESCOBAR AVE
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City | DONNA
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State | TX
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Zip | 78537-3167
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Country | US
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Telephone | 956-278-1317
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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