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Individual
LARA JOHNSON
Active
Individual
LARA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLMHP
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
11904
NE
Other
Enumeration date
12/18/2014
Last updated
06/13/2019
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