Individual
BRENDA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
85 SAINT GEORGE RD, SPRINGFIELD, MA 01104-3333
(413) 732-2120
Mailing address
30 PARKWOOD ST, SPRINGFIELD, MA 01108-2609
(413) 732-2120
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042622756
CCA
MA
01
—
1134107113
MBHP
MA
01
—
1134107113
FALLON
—
05
—
1134107113
—
MA
01
—
12529
HNE
MA
01
—
71756
TUFTS
MA
01
—
997303
NETWORK HEALTH
MA
Enumeration date
03/23/2015
Last updated
03/23/2015
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