Hairston, Larry Dewitt
Hairston, Larry Dewitt is an sole proprietor health care provider with primary practice located at 15 Ponte Brava , Lake Elsinore CA 92532-0233. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Hairston, Larry Dewitt can be contacted via phone (951) 601-6207.Contact Information
Primary practice address
15 Ponte Brava
Lake Elsinore CA 92532-0233
Phone: (951) 601-6207
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | MFC25534 | California |
Profile Details
| NPI number | 1801091699 |
|---|---|
| LBN Legal business name | Hairston, Larry Dewitt |
| Credentials | LMFT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 20th, 2007 |
| Last updated | Dec 11th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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