Individual
DANIELA LARA DAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7526 E 82ND ST, INDIANAPOLIS, IN 46256-1410
(574) 387-4313
Mailing address
215 RED COACH DR, MISHAWAKA, IN 46545-8307
(574) 387-4313
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-288144
IN
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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