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1285133256
SHANE KEITH LOPEZ
BELLE CHASSE, LA
NPI
1285133256
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: LA 6551)
Enumeration Date
2018-02-06
Last Update Date
2019-03-11
Business Address
SHANE KEITH LOPEZ
115 KEATING DR
BELLE CHASSE, LA 70037
Phone number: 504-393-5750
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Mailing Address
SHANE KEITH LOPEZ
115 KEATING DR
BELLE CHASSE, LA 70037-1629
Phone number: 504-393-5750
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