Wibeto, Lara

Wibeto, Lara is an individual health care provider with primary practice located at 4705 Old Post Rd , Charlestown RI 02813-1841. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Wibeto, Lara can be contacted via phone (401) 932-5959.

Contact Information

Primary practice address
4705 Old Post Rd Charlestown RI 02813-1841
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1497292635
LBN Legal business name Wibeto, Lara
Credentials BS
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2017
Last updated Jan 26th, 2017 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497292635 NPPES
Rhode Island MEDICAID 05-0309043

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