Provider Demographics
NPI:1164209185
Name:LOPES, MILKA P
Entity Type:Individual
Prefix:
First Name:MILKA
Middle Name:P
Last Name:LOPES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 JAMES ST # 2
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-3821
Mailing Address - Country:US
Mailing Address - Phone:857-869-5059
Mailing Address - Fax:
Practice Address - Street 1:11 JAMES ST # 2
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3821
Practice Address - Country:US
Practice Address - Phone:857-869-5059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health