Individual
SARA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 N ROSE ST, PHOENIX, OR 97535-5734
(541) 535-1065
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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