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1861745192
GLORIA LARA
PERRIS, CA
NPI
1861745192
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-10-24
Last Update Date
2012-10-24
Business Address
-- GLORIA LARA
2055 N PERRIS BLVD STE G6
PERRIS, CA 92571-2516
Phone number: 951-940-6061
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Mailing Address
-- GLORIA LARA
PO BOX 549
LAKE ELSINORE, CA 92531-0549
Phone number: 951-294-5879
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