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Individual

MR. ROMAN LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1640 E FLAMINGO RD, #100, LAS VEGAS, NV 89119-5249
(702) 369-4357
Mailing address
1640 E FLAMINGO RD, #100, LAS VEGAS, NV 89119-5249
(702) 369-4357

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
NV
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45-3558217
NV
Enumeration date
12/22/2011
Last updated
02/18/2014
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