Individual
SHARON MAE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAC
Contact information
Practice address
152 NORTH 400 WEST, EPHRIAM, UT 84627-2131
(435) 283-8400
(435) 283-8401
Mailing address
PO BOX 119, AURORA, UT 84620-0119
(435) 896-8236
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
124038-6006
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124038-6006
UTAH STATE LICENSE
UT
Enumeration date
01/26/2011
Last updated
01/26/2011
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