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1356791859
JAQUELINE DIANE LARA
ANAHEIM, CA
NPI
1356791859
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 123749)
Enumeration Date
2016-06-15
Last Update Date
2022-07-19
Business Address
JAQUELINE DIANE LARA
2026 W BEACON AVE
ANAHEIM, CA 92804-4406
Phone number: 949-426-3125
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Mailing Address
JAQUELINE DIANE LARA
2026 W BEACON AVE
ANAHEIM, CA 92804-4406
Phone number: 949-426-3125
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