Provider Demographics
NPI:1841422987
Name:LOPEZ, GLORIA H (LMHC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:H
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3336 TORREMOLINOS AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2956
Mailing Address - Country:US
Mailing Address - Phone:786-426-4439
Mailing Address - Fax:305-264-4137
Practice Address - Street 1:9360 SUNSET DR
Practice Address - Street 2:SUITE 234
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5432
Practice Address - Country:US
Practice Address - Phone:305-274-9755
Practice Address - Fax:305-274-4137
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health