Individual
PATRICIA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3574 US 1 S STE 102, ST AUGUSTINE, FL 32086-6467
(904) 217-7161
Mailing address
3574 US 1 S STE 102, ST AUGUSTINE, FL 32086-6467
(904) 217-7161
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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