Individual
JESENIA MERCEDES LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 REDFIELD ST, DORCHESTER, MA 02122-3630
(617) 469-8500
Mailing address
50 REDFIELD ST, DORCHESTER, MA 02122-3630
(617) 469-8500
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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