Individual
MISS LARA PATRICE GAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1044 NORTHWEST BLVD STE C, COEUR D ALENE, ID 83814-2114
(208) 930-1740
(208) 930-1695
Mailing address
PO BOX 544, CLAYTON, CA 94517-0544
(925) 603-0186
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
REG. INTERN 48617
CA
Other
Enumeration date
01/17/2007
Last updated
01/09/2024
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