CHARLES HENRY LAVINE

FORT WORTH, TX
NPI1447482641
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: TX  13146)
Enumeration Date2009-08-20
Last Update Date2009-08-20
Business Address
-- CHARLES HENRY LAVINE LPC-S
2701 BURCHILL RD N
FORT WORTH, TX 76105-3012
Phone number: 817-534-0814
Mailing Address
-- CHARLES HENRY LAVINE LPC-S
2701 BURCHILL RD N
FORT WORTH, TX 76105-3012
Phone number: 817-534-0814