Individual
JOCELYN LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5324 135TH ST, CRESTWOOD, IL 60418-1531
(708) 385-4690
Mailing address
11648 S MERRION LN, MERRIONETTE PARK, IL 60803-4247
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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