Individual
CRYSTAL MIROSALBA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1514 N ZARAGOZA RD STE B4, EL PASO, TX 79936-8041
(915) 257-5782
Mailing address
344 COLMILLO DR, EL PASO, TX 79907-4145
(915) 633-5699
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
112844
TX
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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