Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3247 | PR |
NPI | 1013148659 |
---|---|
Provider Name | Dr. Yamil J Lara |
First Address | Gurabo, PR 00778-3749 |
Second Address | Caguas, PR 00725-3807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2009 |
Last Update Date | 22/07/2014 |