MARIO LARA

PORTAGE, IN
NPI1306118468
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2012-02-06
Last Update Date2012-02-06
Business Address
Mr. MARIO LARA BA
3176 LANCER ST
PORTAGE, IN 46368-4408
Phone number: 219-763-8823
Mailing Address
Mr. MARIO LARA BA
579 W 450 S
HEBRON, IN 46341-8819
Phone number: 219-763-8823
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