Individual
WILLOW LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
405 HUNTER ST, ESPANOLA, NM 87532-2656
(505) 367-3342
Mailing address
PO BOX 2561, TAOS, NM 87571-2561
(575) 770-9811
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-08290
NM
1041S0200X
School Social Worker
385036
NM
Other
Enumeration date
08/10/2023
Last updated
09/12/2023
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