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General NPI Number Information
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NPI Number | 1770700890
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Entity Type | Individual
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Provider Name | BILLI JEAN LOPEZ LISW-S, L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 5151 MONROE ST STE 250E
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City | TOLEDO
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State | OH
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Zip | 43623-3469
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Country | US
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Telephone | 419-684-2178
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Fax |
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Provider Business Mailing Address
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Address Line | 1219 HIGLEY ST
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City | TOLEDO
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State | OH
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Zip | 43612-2328
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Country | US
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Telephone | 419-704-6520
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 13980
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2002497-SUPV
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License Number State | OH
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