Individual
ALAN ROBERT BRAILSFORD DE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW LCAS CSI
Contact information
Practice address
201 N FRONT ST STE 704, WILMINGTON, NC 28401-5090
(910) 769-9126
(910) 769-9169
Mailing address
201 N FRONT ST STE 704, WILMINGTON, NC 28401-5090
(910) 769-9126
(910) 769-9169
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-23672
NC
1041C0700X
Clinical Social Worker
Primary
C012166
NC
Other
Enumeration date
12/06/2018
Last updated
11/21/2021
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