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1285476010
EZRA LAVINSKY
PRESCOTT, AZ
NPI
1285476010
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AZ LPC-22856)
Enumeration Date
2024-06-11
Last Update Date
2024-06-11
Business Address
EZRA LAVINSKY LLC
1579 W GURLEY ST
PRESCOTT, AZ 86305-2829
Phone number: 928-713-3658
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Mailing Address
EZRA LAVINSKY LLC
4656 E CHESHIRE LOOP
PRESCOTT VALLEY, AZ 86314-0086
Phone number: 928-499-1951
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