Provider Demographics
NPI:1275227811
Name:DIAZ LOPEZ, ANA I (MA, LCSW, DSW)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:I
Last Name:DIAZ LOPEZ
Suffix:
Gender:F
Credentials:MA, LCSW, DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PARK LN
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-3317
Mailing Address - Country:US
Mailing Address - Phone:908-295-6431
Mailing Address - Fax:
Practice Address - Street 1:349 ROUTE 31
Practice Address - Street 2:BUILDING A, SUITE 301
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-3317
Practice Address - Country:US
Practice Address - Phone:908-295-6431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC061204001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical