Individual
CRYSTAL DYANN LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
32773 W WALLS RD, HERMISTON, OR 97838-6364
(541) 567-2949
(541) 656-3046
Mailing address
32405 DIAGONAL RD, HERMISTON, OR 97838-7503
(541) 567-2949
(541) 656-3046
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/26/2019
Last updated
12/26/2019
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