Individual
MS. ROBERTA L LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LMHC
Contact information
Practice address
18431 US 84/285, ESPANOLA, NM 87532-9863
(505) 747-4922
Mailing address
18431 US 84/285, ESPANOLA, NM 87532-9863
(505) 747-4922
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0117291
NM
101YM0800X
Mental Health Counselor
Primary
0117291
NM
101YP2500X
Professional Counselor
0117291
NM
Other
Enumeration date
11/24/2008
Last updated
12/04/2008
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