Individual
MRS. STEPHANIE ELLEN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
2080 WOODDALE DR STE 200, WOODBURY, MN 55125-2920
(612) 201-2468
Mailing address
2080 WOODDALE DR STE 200, WOODBURY, MN 55125-2920
(612) 201-2468
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA0528
MN
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/30/2021
Last updated
02/14/2025
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