Individual
EDITH MYLADY LOPEZ RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
11010 SE DIVISION ST # 202, PORTLAND, OR 97266-6400
(503) 335-5975
Mailing address
11010 SE DIVISION ST # 202, PORTLAND, OR 97266-6400
(503) 335-5975
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/05/2018
Last updated
08/05/2018
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