Lara, Richard Brannen
Lara, Richard Brannen is an sole proprietor health care provider with primary practice located at 404 Hunter St , Espanola NM 87532-2655. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Lara, Richard Brannen can be contacted via phone (505) 753-4123.Contact Information
Primary practice address
404 Hunter St
Espanola NM 87532-2655
Phone: (505) 753-4123
Fax: (505) 753-6947
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | X05752 | New Mexico |
Profile Details
| NPI number | 1174651095 |
|---|---|
| LBN Legal business name | Lara, Richard Brannen |
| Credentials | LMSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 1st, 2007 |
| Last updated | Jan 6th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174651095 | NPPES |
| New Mexico | MEDICAID | E7436 |
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