Individual
BRENDA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10252 E 37TH PL, YUMA, AZ 85365-7059
(928) 503-3628
Mailing address
10252 E 37TH PL, YUMA, AZ 85365-7059
(928) 503-3628
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-18298
AZ
101Y00000X
Counselor
Primary
LPC-22476
AZ
Other
Enumeration date
07/19/2021
Last updated
05/04/2026
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