Individual
MR. GILBERT A LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
1047 LAKE DR, SANTA ROSA, NM 88435-2561
(575) 512-6154
(575) 472-5384
Mailing address
1047 LAKE DR, SANTA ROSA, NM 88435-2561
(572) 472-5383
(575) 472-5384
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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