Individual
SHEENA RAE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 SW RAILROAD AVE, HAMMOND, LA 70403-5001
(985) 500-3240
Mailing address
30735 LAVIGNE LN, ALBANY, LA 70711-3135
(985) 415-4157
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
008450607
LA
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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