Individual
ASHLEIGH LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 REGENCY PKWY, MANSFIELD, TX 76063-5638
(817) 405-4120
(682) 334-7806
Mailing address
201 REGENCY PKWY, MANSFIELD, TX 76063-5638
(817) 405-4120
(682) 334-7806
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-135448
—
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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