Individual
JUSTINE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRSS/FPRSS/BHCM I
Contact information
Practice address
101 S HUDSON ST, ALTUS, OK 73521-4215
(580) 301-6154
Mailing address
101 S HUDSON ST, ALTUS, OK 73521-4215
(580) 301-6154
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
175T00000X
Peer Specialist
—
—
Other
Enumeration date
09/26/2023
Last updated
08/01/2025
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