Individual
ANN MARIE LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
629 W 8TH ST, POMONA, CA 91766-3013
(626) 246-2578
Mailing address
629 W 8TH ST, POMONA, CA 91766-3013
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
061282
CA
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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