| NPI | 1679963557 |
|---|---|
| Former Name | DENA LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA S1205271551) |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2019-03-25 |