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General NPI Number Information
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NPI Number | 1285652263
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Entity Type | Individual
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Provider Name | PATRICK FRANCIS LAVIN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 325 MARKET ST SUITE 303
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City | CHATTANOOGA
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State | TN
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Zip | 37402-1226
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Country | US
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Telephone | 423-778-9451
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Fax | 423-778-9453
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Provider Business Mailing Address
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Address Line | 612 VALLEY BRIDGE RD
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City | CHATTANOOGA
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State | TN
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Zip | 37415-3917
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Country | US
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Telephone | 423-877-7232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P 544
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License Number State | TN
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