Provider Demographics
NPI:1255137485
Name:LOPEZ, MARLA JAEL
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:JAEL
Last Name:LOPEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 W 375 N
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-8666
Mailing Address - Country:US
Mailing Address - Phone:562-303-4914
Mailing Address - Fax:
Practice Address - Street 1:4240 W 375 N
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-8666
Practice Address - Country:US
Practice Address - Phone:562-303-4914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter