Provider Demographics
NPI:1578143202
Name:LOPEZ ALMOND, IRENE
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:LOPEZ ALMOND
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 1:1691 SNOW EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:LOMA
Mailing Address - State:CO
Mailing Address - Zip Code:81524-9643
Mailing Address - Country:US
Mailing Address - Phone:970-261-3656
Mailing Address - Fax:
Practice Address - Street 1:605 A 28 1/4 ROAD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506
Practice Address - Country:US
Practice Address - Phone:970-242-9026
Practice Address - Fax:970-257-6246
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional