Individual
CORRIE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 S 6TH ST, 3RD FLOOR, MILWAUKEE, WI 53204-2301
(414) 643-8530
(414) 647-8602
Mailing address
1028 S 9TH ST, MILWAUKEE, WI 53204-1335
(414) 643-8530
(414) 647-8602
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
15230-136
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18010-130
WI
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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