Individual
RICHARD ANTHONY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAC, CAS
Contact information
Practice address
509 E 13TH ST, PUEBLO, CO 81001-2940
(719) 556-6666
Mailing address
509 E 13TH ST, PUEBLO, CO 81001-2940
(719) 546-6666
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0001557
CO
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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