Individual
MAGDALENA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6621 DONIPHAN DR STE G, CANUTILLO, TX 79835-5005
(915) 877-5100
(915) 877-5107
Mailing address
6621 DONIPHAN DR STE G, CANUTILLO, TX 79835-5005
(915) 877-5100
(915) 877-5107
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Enumeration date
09/23/2009
Last updated
09/23/2009
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