Organization
AMY LOPEZ COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY LYNN LOPEZ LPC (SOLE MEMBER/OWNER)
(262) 955-9804
Entity
Organization
Contact information
Practice address
4402 S 68TH ST, SUITE 100, GREENFIELD, WI 53220-3479
(262) 955-9804
(414) 321-0552
Mailing address
4402 S 68TH ST, SUITE 100, GREENFIELD, WI 53220-3479
(262) 955-9804
(414) 321-0552
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639301104
—
WI
Enumeration date
11/17/2014
Last updated
11/17/2014
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