Individual
ANA LAURA LARA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8350 NW 103RD ST APT 205, HIALEAH GARDENS, FL 33016-4655
(786) 667-0612
Mailing address
8350 NW 103RD ST APT 205, HIALEAH GARDENS, FL 33016-4655
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-261807
FL
Other
Enumeration date
08/04/2023
Last updated
08/04/2023
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