Individual
CHANEL SHANNI LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
1772 STIEGER LAKE LN, VICTORIA, MN 55386-7723
(952) 443-4600
Mailing address
1772 STIEGER LAKE LN, VICTORIA, MN 55386-7723
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4430
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/26/2021
Last updated
06/07/2024
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