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1447482641
CHARLES HENRY LAVINE
FORT WORTH, TX
NPI
1447482641
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: TX 13146)
Enumeration Date
2009-08-20
Last Update Date
2009-08-20
Business Address
-- CHARLES HENRY LAVINE LPC-S
2701 BURCHILL RD N
FORT WORTH, TX 76105-3012
Phone number: 817-534-0814
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Mailing Address
-- CHARLES HENRY LAVINE LPC-S
2701 BURCHILL RD N
FORT WORTH, TX 76105-3012
Phone number: 817-534-0814
Copy
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