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Individual
MR. GUSTAVO DANIEL LOPEZ
Active
Individual
MR. GUSTAVO DANIEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT R1500990323
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/18/2025
Last updated
04/23/2025
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