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Individual
JENNIFER TRAVIESO
Active
Individual
JENNIFER TRAVIESO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA17191
FL
235Z00000X
Speech-Language Pathologist
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101010300
—
FL
01
—
841900085
TAX ID
FL
Enumeration date
09/20/2018
Last updated
08/13/2019
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