Organization
DIANNE LAVIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNE LAVIN PSYD, RN (PROVIDER/OWNER)
(210) 441-1074
Entity
Organization
Contact information
Practice address
503 BENEDICT CT, SAN ANTONIO, TX 78258-2545
(210) 441-1074
(210) 441-1074
Mailing address
3955 PALM WAY STE 1, JACKSONVILLE BEACH, FL 32250-3005
(904) 685-4850
(904) 685-4850
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
33606
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3587
TX
Other
Enumeration date
06/13/2017
Last updated
08/17/2017
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