Individual
MARIBEL ANGELIQUE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
419 S 2ND ST, TUCUMCARI, NM 88401-2859
(575) 461-9907
(575) 461-9867
Mailing address
392, TUCUMCARI, NM 88401
(575) 461-9907
(575) 461-9867
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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