NPI | 1669363214 |
---|---|
Former Name | LILIA TRACEY LARA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1419440525) |
Enumeration Date | 2025-07-11 |
Last Update Date | 2025-07-14 |