LARRY DEWITT HAIRSTON

LAKE ELSINORE, CA
NPI1801091699
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy106H00000X Marriage & Family Therapist
(Licence: CA  MFC25534)
Enumeration Date2007-06-20
Last Update Date2014-12-11
Business Address
-- LARRY DEWITT HAIRSTON LMFT
15 PONTE BRAVA
LAKE ELSINORE, CA 92532-0233
Phone number: 951-601-6207
Mailing Address
-- LARRY DEWITT HAIRSTON LMFT
15 PONTE BRAVA
LAKE ELSINORE, CA 92532-0233
Phone number: 951-601-6207