Individual
JUAN G LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
13376 1ST AVE, PARKER, AZ 85344
(928) 669-5243
Mailing address
12302 KENNEDY DR, PARKER, AZ 85344-9734
(928) 669-5243
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/07/2013
Last updated
05/07/2013
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