Individual
GLORYVEE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
SAN JUAN 409, BARRIO CORTES, MANATI, PR 00674
(787) 623-2883
Mailing address
RR 2 BOX 8123, MANATI, PR 00674-9629
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
TAC-III-05-20-4080
PR
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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