Organization
LAVENDER AVENUE THERAPEUTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASMINE T IRVIN PHD (PRESIDENT)
(919) 302-2308
Entity
Organization
Contact information
Practice address
210 W LAVENDER AVE, DURHAM, NC 27704-4251
(919) 302-2308
Mailing address
210 W LAVENDER AVE, DURHAM, NC 27704-4251
(919) 302-2308
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4548
NC
Other
Enumeration date
05/20/2015
Last updated
05/20/2015
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