Individual
BENJAMIN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4101 COUNTY ROAD 222, DURANGO, CO 81303-6703
(970) 563-5700
(970) 563-4885
Mailing address
PO BOX 737, IGNACIO, CO 81137-0737
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0008682
CO
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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