Provider Demographics
NPI:1649565136
Name:LITTLE LIGHT, LLC
Entity Type:Organization
Organization Name:LITTLE LIGHT, LLC
Other - Org Name:LITTLE LIGHT HEALING ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LUMENELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:520-326-8456
Mailing Address - Street 1:3844 E PIMA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3308
Mailing Address - Country:US
Mailing Address - Phone:520-326-8456
Mailing Address - Fax:
Practice Address - Street 1:3844 E PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3308
Practice Address - Country:US
Practice Address - Phone:520-326-8456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ462171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty