Individual
MELINDA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBP
Contact information
Practice address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 248-5780
Mailing address
1215 E ASTER AVE, FREDERICK, OK 73542-7817
(580) 335-1215
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0025
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100747400B
—
OK
Enumeration date
07/17/2009
Last updated
03/25/2019
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