| NPI | 1851652655 |
|---|---|
| Former Name | LARA LYNN BRABHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 31523) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 022307) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2026-01-05 |