Individual
EZEQUIEL R LOPES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
794 MASSACHUSETTS AVE, BOSTON, MA 02118-2319
(617) 534-9158
Mailing address
1010 MASSACHUSETTES AVENUE, BOSTON, MA 02118
(617) 419-3408
(617) 534-2611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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