JACK S TRAVIS

SAYVILLE, NY
NPI1740464106
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NY  076632)
Enumeration Date2007-12-20
Last Update Date2011-06-11
Business Address
Mr. JACK S TRAVIS LMSW
80 SAXTON AVE
SAYVILLE, NY 11782-2610
Phone number: 631-987-2751
Mailing Address
Mr. JACK S TRAVIS LMSW
208 MEDEA WAY
CENTRAL ISLIP, NY 11722-4540
Phone number: 631-987-2751
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