Individual
MRS. MARLENE MERCEDES LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-LISAC
Contact information
Practice address
1324 S PEDEN CT, CHANDLER, AZ 85286-7629
(480) 652-4820
Mailing address
1324 S PEDEN CT, CHANDLER, AZ 85286-7629
(480) 652-4820
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC10828
AZ
101YP2500X
Professional Counselor
Primary
LPC-13324
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
477673
—
AZ
Enumeration date
10/26/2009
Last updated
01/20/2016
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