Individual
JULIANA LARES COLLASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
149 PASADENA AVE STE A, SOUTH PASADENA, CA 91030-3351
(323) 274-3065
Mailing address
940 AVENUE 64, PASADENA, CA 91105-2711
(323) 543-2800
(323) 978-1263
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10391
CA
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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