Provider Demographics
NPI:1548823057
Name:LOPEZ, LAURA J (MSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:J
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ORQUIDEA R 15
Mailing Address - Street 2:VILLA SERENA
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3326
Mailing Address - Country:US
Mailing Address - Phone:787-396-0337
Mailing Address - Fax:
Practice Address - Street 1:109 CALLE ANTONIO R. BARCELO
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-878-5778
Practice Address - Fax:787-878-5778
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR73471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical