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Individual

CONSTANTINO LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CADC

Contact information

Practice address
1610 WOODS CT, HOOD RIVER, OR 97031-2911
(541) 386-2620
Mailing address
419 E 7TH ST STE 207, THE DALLES, OR 97058-2676
(541) 296-5452

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
96-04-143 CADCII
OR

Other

Enumeration date
10/27/2010
Last updated
10/27/2010
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