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1467029009
KRISTINE LEIGH TAVRISOV
JACKSONVILLE, FL
NPI
1467029009
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: FL SA20512)
Enumeration Date
2021-06-10
Last Update Date
2023-10-18
Business Address
KRISTINE LEIGH TAVRISOV M.S. CCC-SLP
11420 CAMPFIELD CIR
JACKSONVILLE, FL 32256-3907
Phone number: 904-910-1065
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Mailing Address
KRISTINE LEIGH TAVRISOV M.S. CCC-SLP
11420 CAMPFIELD CIR
JACKSONVILLE, FL 32256-3907
Phone number: 904-910-1065
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