# LAVENDER FLORANCE LICENSED MARRIAGE AND FAMILY THERAPIST PROFESSIONAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467270561
- **Authorized official:** LAVENDER FLORANCE LMFT (CEO)
- **Authorized official phone:** (949) 441-0011

## Contact information

- **Practice address:** 242 W MAIN ST STE 104, TUSTIN, CA 92780-7715
- **Practice address phone:** (949) 441-0011
- **Mailing address:** 242 W MAIN ST STE 104, TUSTIN, CA 92780-7715
- **Mailing address phone:** (949) 441-0011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 09/28/2024
- **Last updated:** 09/28/2024