Provider Demographics
NPI:1841759206
Name:LUNA, CALEE ROSE
Entity Type:Individual
Prefix:
First Name:CALEE
Middle Name:ROSE
Last Name:LUNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1N254 LAFOX ROAD
Mailing Address - Street 2:
Mailing Address - City:LAFOX
Mailing Address - State:IL
Mailing Address - Zip Code:60147
Mailing Address - Country:US
Mailing Address - Phone:630-391-0388
Mailing Address - Fax:
Practice Address - Street 1:1N254 LAFOX ROAD
Practice Address - Street 2:
Practice Address - City:LAFOX
Practice Address - State:IL
Practice Address - Zip Code:60147
Practice Address - Country:US
Practice Address - Phone:630-391-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician