Organization
LUMATE NORTH CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DETWEILER PHD (CEO)
(210) 872-9611
Entity
Organization
Contact information
Practice address
3600 N DUKE ST # 1191, DURHAM, NC 27704-1709
(210) 872-9611
Mailing address
3600 N DUKE ST # 1191, DURHAM, NC 27704-1709
(210) 872-9611
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
02/01/2023
Last updated
02/07/2023
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