Individual
MELISSA A LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CM-D, CADC
Contact information
Practice address
225 E EVANS AVE, SEMINOLE, OK 74868-3423
(405) 382-5438
Mailing address
43320 BELLE BROOK CIR, SHAWNEE, OK 74804-9140
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
UNDER SUPERVISION
—
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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