NPI | 1124883160 |
---|---|
Doing Business As | LUMINOUS HEALTHCARE |
Entity Type | Organization |
Authorized Contact | DAVID OPOLLO ROSS Clinical Director 360-602-2620 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Enumeration Date | 2024-02-19 |
Last Update Date | 2024-07-11 |