Individual
LARA CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3109 W DR MARTIN LUTHER KING JR BLVD STE AND501, TAMPA, FL 33607-6260
(813) 289-0760
Mailing address
3109 W DR MARTIN LUTHER KING JR BLVD STE AND501, TAMPA, FL 33607-6260
(813) 289-0760
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
RBT-24-364416
MD
Other
Enumeration date
09/06/2024
Last updated
09/30/2024
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