Provider Demographics
NPI:1750596144
Name:ARROYO-LOPEZ, JESUS (LMT, MMP)
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:
Last Name:ARROYO-LOPEZ
Suffix:
Gender:M
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BENEFIT ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-1832
Mailing Address - Country:US
Mailing Address - Phone:415-342-0457
Mailing Address - Fax:
Practice Address - Street 1:134 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1923
Practice Address - Country:US
Practice Address - Phone:781-472-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA12640225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor