Individual
MISS CHARMAINE DIANNA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2741 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-2653
(505) 750-8866
Mailing address
601 LOVEJOY RD SW, ALBUQUERQUE, NM 87105-3849
(505) 440-4018
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0166601
NM
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/11/2008
Last updated
11/04/2014
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