Individual
EVANGELINA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDA
Contact information
Practice address
255A S CAMINO DEL PUEBLO, BERNALILLO, NM 87004-5973
(505) 867-2356
Mailing address
1101 LOPEZ RD SW, ALBUQUERQUE, NM 87105-3954
(505) 877-7060
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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