Individual
EILEEN ISAMAR LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 WARREN ST, BRIGHTON, MA 02135-3680
(617) 293-0418
Mailing address
18 ALGONQUIN ST APT 5, DORCHESTER, MA 02124-1150
(617) 293-0418
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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