| Doctor Name: | MELISSA A LOPEZ |
| NPI Number: | 1124238365 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CM-D, CADC |
| License Number: | UNDER SUPERVISION |
| Business Practice Address: | 225 E Evans Ave Seminole, OK - 748683423 |
| Business Phone Number: | 4053825438 |
| Business Fax Number: | |
| Mailing Address: | 43320 Belle Brook Cir, SHAWNEE |
| State: | OK |
| Postal Code: | 748049140 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | UNDER SUPERVISION |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |