Individual
CARMEN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
15731 NE 117TH ST, REDMOND, WA 98052-2298
(425) 301-6669
Mailing address
4528 ALABAMA ST, SAN DIEGO, CA 92116-2723
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MG61355200
MARRIAGE AND FAMILY THERAPIST ASSOCIATE LICENSE
WA
Enumeration date
09/15/2022
Last updated
09/15/2022
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