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General NPI Number Information
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NPI Number | 1467115634
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Entity Type | Organization
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Legal Business Name | THE LIGHTHOUSE LEARNING CENTER
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 5502 58TH ST STE 500
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City | LUBBOCK
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State | TX
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Zip | 79414-2087
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Country | US
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Telephone | 979-806-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 5139 69TH ST
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City | LUBBOCK
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State | TX
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Zip | 79424-1601
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Country | US
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Telephone | 979-323-4352
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MARI LUCI CERDA
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Credential | PH.D, BCBA, LBA-TX
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Telephone | 806-702-4379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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