Individual
STACIE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1174 N LEATHERLEAF LOOP STE 250, WASILLA, AK 99654-6514
(907) 376-4880
(907) 349-4885
Mailing address
1174 N LEATHERLEAF LOOP, WASILLA, AK 99654-6514
(907) 376-4880
(907) 349-4885
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
106484
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106484
LICENSE
TX
Enumeration date
12/27/2011
Last updated
01/14/2026
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