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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 10 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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