Benjamin Lara's National Provider Identifier (NPI) Details
Benjamin Lara, LMSW
NPI: 1063846764
Enumeration Date: 2013-08-29
Last updated: 2013-08-29
Sole Proprietor: NO
Status: active
Postal Address: 5859 MILLWRIGHT AVE, GARDEN CITY, ID
Phone: 208-433-0400
Primary Practice Address: 9196 W BARNES DR, BOISE, ID
Practice's phone: 208-433-0400