Individual
MRS. ELBA IRIS LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CADC
Contact information
Practice address
1116 N KEDZIE AVE, CHICAGO, IL 60651-4152
(773) 772-8009
(773) 292-5490
Mailing address
1116 N. KEDZIE AVENUE, CHICAGO, IL 60651-4152
(773) 772-8009
(773) 292-5490
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2009
Last updated
06/21/2011
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