Individual
ROBERTA LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 10TH AVE SE APT 2, DEVILS LAKE, ND 58301-7600
(701) 230-0293
Mailing address
1401 10TH AVE SE APT 2, DEVILS LAKE, ND 58301-7600
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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