Individual
PAMELA LUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, MHP
Contact information
Practice address
406 E VINE ST, VIENNA, IL 62995-1612
(618) 658-3079
(618) 658-2759
Mailing address
406 E VINE ST, VIENNA, IL 62995-1612
(618) 658-3079
(618) 658-2759
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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