Provider Demographics
NPI:1548561020
Name:LOPES, SOLANGE F
Entity Type:Individual
Prefix:
First Name:SOLANGE
Middle Name:F
Last Name:LOPES
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 1:85 PARK ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-2915
Mailing Address - Country:US
Mailing Address - Phone:617-606-2099
Mailing Address - Fax:508-427-9336
Practice Address - Street 1:85 PARK ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-2915
Practice Address - Country:US
Practice Address - Phone:617-606-2099
Practice Address - Fax:508-427-9336
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8942225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist