Individual
AMANDA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8613 W COUNTY ROAD 60, MIDLAND, TX 79707-1357
(432) 694-7728
Mailing address
7212 W ARTIE ST, ODESSA, TX 79763-7506
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
75288
TX
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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