Individual
CHIPPY LAVACHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 S GARNETT ST, HENDERSON, NC 27536-4509
(919) 226-3180
(919) 226-3183
Mailing address
630 S GARNETT ST, HENDERSON, NC 27536-4509
(919) 226-3180
(919) 226-3183
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-032-525
NC
Other
Enumeration date
01/03/2014
Last updated
01/03/2014
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