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
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/12/2023
Last updated
03/14/2023
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