Individual
LARA OGBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10280 SE 160TH PL, WHITE SPRINGS, FL 32096-2571
(386) 984-6906
Mailing address
10280 SE 160TH PL, WHITE SPRINGS, FL 32096-2571
(386) 984-6906
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018070700
—
FL
Enumeration date
06/16/2016
Last updated
05/02/2025
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