| Doctor Name: | LARA WEST |
| NPI Number: | 1710004080 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 39001808A |
| Business Practice Address: | 101 Suzie Ln Suite 1 Attica, IN - 479182009 |
| Business Phone Number: | 7657626187 |
| Business Fax Number: | |
| Mailing Address: | 3020 Pheasant Run Dr Apt 1814, LAFAYETTE |
| State: | IN |
| Postal Code: | 479094014 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 39001808A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |