Organization
LUMEN PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLLE MEHR (CHIEF EXECUTIVE OFFICER)
(888) 485-8636
Entity
Organization
Contact information
Practice address
26210 HARPER AVE STE 200, SAINT CLAIR SHORES, MI 48081-2203
(888) 485-8636
(586) 218-3367
Mailing address
26210 HARPER AVE STE 200, SAINT CLAIR SHORES, MI 48081-2203
(888) 485-8636
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/25/2022
Last updated
02/11/2025
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