Individual
SEAN MIYAKI LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOT
Contact information
Practice address
505 ELM ST NE, ALBUQUERQUE, NM 87102-2500
(505) 727-3601
(505) 727-9840
Mailing address
505 ELM ST NE, ALBUQUERQUE, NM 87102-2500
(505) 727-3601
(505) 727-9840
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
OT4676
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT4676
NM OT LICENSE
NM
Enumeration date
11/10/2022
Last updated
11/29/2022
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