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General NPI Number Information
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NPI Number | 1760892418
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Entity Type | Individual
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Provider Name | KATHIA Y LOPEZ MURDOCK LCPC
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Gender | Female
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Dates
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Enumeration Date | 05/03/2014
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Last Update Date | 05/03/2014
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Provider Practice Location Address
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Address Line | 3717 N RAVENSWOOD AVE SUITE 110
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City | CHICAGO
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State | IL
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Zip | 60613-3880
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Country | US
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Telephone | 773-470-8228
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Fax |
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Provider Business Mailing Address
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Address Line | 3717 N RAVENSWOOD AVE SUITE 110
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City | CHICAGO
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State | IL
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Zip | 60613-3880
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Country | US
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Telephone | 773-470-8228
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180007922
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License Number State | IL
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