Individual
ELLEN LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
30-32R GIFFORD ST, NEW BEDFORD, MA 02744
(508) 999-3126
(508) 991-8579
Mailing address
PO BOX 2097, NEW BEDFORD, MA 02741-2097
(508) 999-3126
(508) 991-8579
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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