Individual
DR. SANDRA LARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2609 S 10TH AVE STE 102, CALDWELL, ID 83605-6885
(208) 454-2766
Mailing address
702 SUNSET DR, ONTARIO, OR 97914-3121
(541) 889-9167
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0479
SC
2084P0800X
Psychiatry Physician
Primary
2005-01564
NC
2084P0800X
Psychiatry Physician
20A7836
CA
Other
Enumeration date
10/27/2006
Last updated
02/23/2021
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