Individual
LARA MONICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.C.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-6057
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2757
MS
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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