Provider Demographics
NPI:1497858450
Name:LOPEZ-AQUINO, WILNELIA (OTL)
Entity type:Individual
Prefix:MS
First Name:WILNELIA
Middle Name:
Last Name:LOPEZ-AQUINO
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 AVE ARCADIO ESTRADA
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0998
Mailing Address - Country:US
Mailing Address - Phone:787-546-5734
Mailing Address - Fax:787-773-1014
Practice Address - Street 1:4160 AVE ARCADIO ESTRADA
Practice Address - Street 2:SUITE 209
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-0998
Practice Address - Country:US
Practice Address - Phone:787-546-5734
Practice Address - Fax:787-773-1014
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR869225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist