Individual
CANDACE MARIE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW PCSW
Contact information
Practice address
2521 E 15TH ST, CASPER, WY 82609-4126
(307) 258-9956
Mailing address
1446 KIT CARSON AVE, CASPER, WY 82604-3115
(307) 258-9956
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PCSW-502
WY
Other
Enumeration date
03/05/2013
Last updated
03/05/2013
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