Individual
MIRANDA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10717 JORDAN CT, PARKER, CO 80134-7615
(303) 840-6494
(303) 805-0602
Mailing address
10717 JORDAN CT, PARKER, CO 80134-7615
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1331
CO
Other
Enumeration date
02/17/2011
Last updated
02/17/2011
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