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General NPI Number Information
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NPI Number | 1649938903
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Entity Type | Individual
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Provider Name | LUZ MARINA LOPEZ LMHC
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Gender | Female
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Dates
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Enumeration Date | 12/03/2021
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 138 NE 1ST ST # A-204
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6604
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Country | US
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Telephone | 954-205-6546
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Fax |
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Provider Business Mailing Address
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Address Line | 210 NE 12TH AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6460
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Country | US
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Telephone | 954-257-1008
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH19892
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License Number State | FL
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