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1194938480
GUSTAVO LOPEZ
TRUCKEE, CA
NPI
1194938480
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-07
Last Update Date
2007-07-08
Business Address
-- GUSTAVO LOPEZ
10015 PALISADES DR STE 1
TRUCKEE, CA 96161-1941
Phone number: 530-587-8194
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Mailing Address
-- GUSTAVO LOPEZ
PO BOX 1344
TRUCKEE, CA 96160-1344
Phone number: 530-587-8194
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