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1992066203
EZEQUIEL R LOPES
BOSTON, MA
NPI
1992066203
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-06-04
Last Update Date
2012-06-04
Business Address
-- EZEQUIEL R LOPES
794 MASSACHUSETTS AVE
BOSTON, MA 02118-2319
Phone number: 617-534-9158
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Mailing Address
-- EZEQUIEL R LOPES
1010 MASSACHUSETTES AVENUE
BOSTON, MA 02118
Phone number: 617-419-3408
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