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1023572583
MYRA DINA LOPEZ
VICTORVILLE, CA
NPI
1023572583
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCSW96658)
Enumeration Date
2019-01-29
Last Update Date
2021-02-13
Business Address
MYRA DINA LOPEZ ACSW
15434 W SAGE ST
VICTORVILLE, CA 92392-9751
Phone number: 760-843-0506
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Mailing Address
MYRA DINA LOPEZ ACSW
15388 LINDEN ST
HESPERIA, CA 92345-2825
Phone number: 760-552-9556
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