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1669005245
CHRISTINA LACIVITA
FORT WORTH, TX
NPI
1669005245
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX 64317)
Enumeration Date
2020-02-21
Last Update Date
2020-02-21
Business Address
CHRISTINA LACIVITA
6115 CAMP BOWIE BLVD STE 220
FORT WORTH, TX 76116-5543
Phone number: 817-381-0633
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Mailing Address
CHRISTINA LACIVITA
6115 CAMP BOWIE BLVD STE 220
FORT WORTH, TX 76116-5543
Phone number: 817-381-0633
Copy
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