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1073130720
ANDREW ANTHONY LARA
FAIRBANKS, AK
NPI
1073130720
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-06-29
Last Update Date
2020-06-29
Business Address
ANDREW ANTHONY LARA
1825 MARIKA RD
FAIRBANKS, AK 99709-5521
Phone number: 907-488-0890
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Mailing Address
ANDREW ANTHONY LARA
1825 MARIKA RD
FAIRBANKS, AK 99709-5521
Phone number: 907-474-0890
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