Individual
LARA KELLY PERRETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2744 S 17TH ST, WILMINGTON, NC 28412-6606
(910) 452-1114
Mailing address
2744 S 17TH ST, WILMINGTON, NC 28412-6606
(910) 452-1114
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
IA
235Z00000X
Speech-Language Pathologist
Primary
3673
NC
Other
Enumeration date
01/30/2023
Last updated
12/16/2024
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