Tavarez Lopez, Lorraine

Tavarez Lopez, Lorraine is an sole proprietor health care provider with primary practice located at 1057 Oakland Dr , Elgin SC 29045-9279. She recently has 4 registered licenses in different health care specialties including Agencies / Early Intervention Provider Agency, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, Behavioral Health & Social Service Providers / School. Agencies / Early Intervention Provider Agency is her primary health care specialty. Tavarez Lopez, Lorraine can be contacted via phone (754) 779-0584.

Contact Information

Primary practice address
1057 Oakland Dr Elgin SC 29045-9279
Phone: (754) 779-0584
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Early Intervention Provider Agency 252Y00000X
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X 4657 South Carolina
Behavioral Health & Social Service Providers / School 103TS0200X 4657 South Carolina

Profile Details

NPI number 1770948457
LBN Legal business name Tavarez Lopez, Lorraine
Credentials LPES
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 22nd, 2015
Last updated Jun 8th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770948457 NPPES
South Carolina MEDICAID LP1011

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