Individual
LARA WIBETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
4705 OLD POST RD, CHARLESTOWN, RI 02813-1841
(401) 932-5959
Mailing address
4705 OLD POST RD, CHARLESTOWN, RI 02813-1841
(401) 932-5959
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05-0309043
—
RI
Enumeration date
01/26/2017
Last updated
01/26/2017
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