# DRLULLABY, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1063128635
- **Legal business name:** DRLULLABY, LLC
- **Authorized official:** LISA ANN MEDALIE (CEO)
- **Authorized official phone:** (619) 997-5759

## Contact information

- **Practice address:** 1102A DELAWARE AVE, MCCOMB, MS 39648-3830
- **Practice address phone:** (844) 475-3379
- **Mailing address:** 1440 W TAYLOR ST \# 556, CHICAGO, IL 60607-4623
- **Mailing address phone:** (844) 475-3379

## Taxonomy

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

## Other

- **Enumeration date:** 01/26/2023
- **Last updated:** 03/21/2023