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General NPI Number Information
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NPI Number | 1336826403
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Entity Type | Organization
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Legal Business Name | LAURA LUGO, LICENSED MARRIAGE AND FAMILY THERAPIST, INC
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 945 WESTWIND DR
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City | EL CENTRO
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State | CA
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Zip | 92243-4365
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Country | US
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Telephone | 760-332-8844
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Fax | 760-459-1762
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Provider Business Mailing Address
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Address Line | PO BOX 4402
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City | EL CENTRO
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State | CA
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Zip | 92244-4402
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Country | US
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Telephone | 760-332-8844
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Fax | 760-459-1762
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Authorized Official
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Title or Position | OWNER
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Name | LAURA LUGO
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Credential |
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Telephone | 760-332-8844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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