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Organization
DRLULLABY LLC
Active
Organization
DRLULLABY LLC
Active
Parent organization
DRLULLABY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DRLULLABY LLC
Authorized official
LISA ANN MEDALIE (CEO)
(619) 997-5759
Entity
Organization
Contact information
Practice address
4380 67TH DR # 1033, UNION GROVE, WI 53182-9338
(844) 475-3379
(855) 644-2985
Mailing address
1440 W TAYLOR ST # 556, CHICAGO, IL 60607-4623
(844) 475-3379
(855) 644-2985
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/12/2023
Last updated
03/14/2023
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