Individual
BROOKE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8376 HERCULES ST, LA MESA, CA 91942-2902
(619) 667-6891
Mailing address
8376 HERCULES ST, LA MESA, CA 91942-2902
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
84020
CA
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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