Individual
DOUGLAS R LAVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.D.C.
Contact information
Practice address
352 ROUTE 87, COLUMBIA, CT 06237-1422
(860) 456-4567
Mailing address
352 ROUTE 87, COLUMBIA, CT 06237-1422
(860) 456-4567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000652
CT
Other
Enumeration date
05/19/2006
Last updated
07/23/2007
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