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General NPI Number Information
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NPI Number | 1649586728
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Entity Type | Individual
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Provider Name | RACHEL SALES LOPEZ LAC, LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 6445 MULLAN RD APT B
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City | MISSOULA
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State | MT
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Zip | 59808-5615
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Country | US
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Telephone | 406-745-5555
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Fax | 406-745-2627
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Provider Business Mailing Address
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Address Line | 6445 MULLAN RD APT B
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City | MISSOULA
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State | MT
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Zip | 59808-5615
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Country | US
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Telephone | 406-745-5555
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Fax | 406-745-2627
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 906
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1031
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License Number State | MT
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