| Lighthouse Pediatric Therapy | |
|
11174 E 13 Mile Rd Warren MI 48093-2559 | |
| (313) 285-3978 | |
| Not Available |
| Full Name | Lighthouse Pediatric Therapy |
|---|---|
| Speciality | Pediatrics - Developmental - Behavioral Pediatrics |
| Location | 11174 E 13 Mile Rd, Warren, Michigan |
| Authorized Official Name and Position | Allyson Doll Andrews (CEO) |
| Authorized Official Contact | 3132853978 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Pediatric Therapy 11174 E 13 Mile Rd Warren MI 48093-2559 Ph: (313) 285-3978 | Lighthouse Pediatric Therapy 11174 E 13 Mile Rd Warren MI 48093-2559 Ph: (313) 285-3978 |
| NPI Number | 1083365639 |
|---|---|
| Provider Enumeration Date | 01/14/2022 |
| Last Update Date | 06/22/2026 |
| Certification Date | 06/22/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083365639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | (* (Not Available)) | Primary |
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