Individual
RED DAWN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 MINTER LN, RIVERTON, WY 82501-8959
(307) 856-2643
Mailing address
11 MINTER LN, RIVERTON, WY 82501-8959
(307) 856-2643
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/28/2019
Last updated
02/28/2019
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