Individual
ROBIN M LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
414 SHOUP AVE W, SUITE B, TWIN FALLS, ID 83301-5042
(208) 814-9100
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 814-9100
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW - 33723
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932369956
—
ID
Enumeration date
06/12/2008
Last updated
09/16/2014
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