Provider Demographics
NPI:1235455676
Name:LOPEZ, MARITZA
Entity Type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MUSEUM SQ APT 704
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1538
Mailing Address - Country:US
Mailing Address - Phone:978-686-8202
Mailing Address - Fax:978-686-1281
Practice Address - Street 1:599 CANAL ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1244
Practice Address - Country:US
Practice Address - Phone:978-686-8202
Practice Address - Fax:978-686-8202
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor