Individual
MRS. ANNIE KATHLEEN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
201 CEDAR ST SE STE 4660, ALBUQUERQUE, NM 87106-4924
(505) 563-6530
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NM
1041C0700X
Clinical Social Worker
Primary
C-11619
NM
Other
Enumeration date
08/28/2009
Last updated
02/10/2022
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