# DRLULLABY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DRLULLABY LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003520149
- **Legal business name:** DRLULLABY LLC
- **Authorized official:** LISA ANN MEDALIE (CEO)
- **Authorized official phone:** (619) 997-5759

## Contact information

- **Practice address:** 4380 67TH DR \# 1033, UNION GROVE, WI 53182-9338
- **Practice address phone:** (844) 475-3379
- **Practice address fax:** (855) 644-2985
- **Mailing address:** 1440 W TAYLOR ST \# 556, CHICAGO, IL 60607-4623
- **Mailing address phone:** (844) 475-3379
- **Mailing address fax:** (855) 644-2985

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | NULL | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/12/2023
- **Last updated:** 03/14/2023