Organization
LUMOS WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOEL L'ESPERANCE DAT, ATR-BC, LPC (OWNER, COUNSELOR, ART THERAPIST)
(920) 379-2566
Entity
Organization
Contact information
Practice address
325 W SILVER SPRING DR # 2FE, GLENDALE, WI 53217-5000
(920) 379-2566
Mailing address
325 W SILVER SPRING DR # 2FE, GLENDALE, WI 53217-5000
(920) 379-2566
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4921
WI
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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