Individual
ERICA ANN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
9336 W CHAD ST, BOISE, ID 83709-0558
(208) 724-9483
Mailing address
9336 W CHAD ST, BOISE, ID 83709-0558
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LMSW-33045
ID
104100000X
Social Worker
Primary
LMSW- 33045
ID
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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