Doctor Name: | SOCORRO LOPEZ |
NPI Number: | 1295043156 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 341207 |
Business Practice Address: | 520 N Main St Belen, NM - 870023720 |
Business Phone Number: | 5059661866 |
Business Fax Number: | 5059661865 |
Mailing Address: | 520 N Main St, BELEN |
State: | NM |
Postal Code: | 870023720 |
Phone Number: | 5059661866 |
Fax Number: | 5059661865 |
NPI Enumeration Date: | 09/14/2010 |
NPI Last Update Date: | 09/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 341207 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |