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Individual
LARA LEE-REAVIS
Active
Individual
LARA LEE-REAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1066356
OR
Other
Enumeration date
02/14/2014
Last updated
02/14/2014
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