Doctor Name: | RADAMES MUNIZ LOPEZ |
NPI Number: | 1306095005 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW-R |
License Number: | 032015 |
Business Practice Address: | 743 Columbia Tpke East Greenbush, NY - 120612266 |
Business Phone Number: | 5184777535 |
Business Fax Number: | 5184777555 |
Mailing Address: | 743 Columbia Tpke, EAST GREENBUSH |
State: | NY |
Postal Code: | 120612266 |
Phone Number: | 5184777535 |
Fax Number: | 5184777555 |
NPI Enumeration Date: | 09/17/2008 |
NPI Last Update Date: | 09/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 032015 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |