Individual
LARA D YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
713 W BROAD ST, FORNEY, TX 75126-9147
(972) 552-5559
(972) 552-5499
Mailing address
711 W BROAD ST, FORNEY, TX 75126-9130
(972) 552-5559
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
66670
TX
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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