| 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 |