Individual
CAYLA TRAVIESA DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 898-7451
Mailing address
4703 W CLEAR AVE, TAMPA, FL 33629-5511
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA15818
FL
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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