Individual
BIANCA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7520 NW 5TH ST STE 200, PLANTATION, FL 33317-1613
(954) 903-7285
Mailing address
261 N UNIVERSITY DR STE 500, PLANTATION, FL 33324-2009
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMH21450
FL
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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