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1790482016
GUSTAVO LARA
VISALIA, CA
NPI
1790482016
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-02-08
Last Update Date
2023-02-08
Business Address
GUSTAVO LARA
1731 W WALNUT AVE
VISALIA, CA 93277-6232
Phone number: 559-732-4885
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Mailing Address
GUSTAVO LARA
1731 W WALNUT AVE
VISALIA, CA 93277-6232
Phone number: 559-732-4885
Copy
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