Individual
MIRIAM LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 FOXCROFT AVE STE 104, MARTINSBURG, WV 25401-5302
(304) 513-3495
Mailing address
1005 WHITE WILLOW WAY, MORGANTOWN, WV 26505-6119
(304) 513-3495
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
24059
MD
104100000X
Social Worker
Primary
BP00947408
WV
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/25/2019
Last updated
04/15/2026
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