Individual
CECILLE DE LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(410) 916-7447
Mailing address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(410) 916-7447
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
R145794
MD
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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