Individual
AMBER MARIE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPS MRSS
Contact information
Practice address
925 HIGHWAY VV, KENNETT, MO 63857
(573) 888-5925
Mailing address
925 HIGHWAY VV, KENNETT, MO 63857
(573) 888-5925
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175T00000X
175T00000X
MO
Enumeration date
03/14/2022
Last updated
03/14/2022
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