Individual
BILLIE JO REVELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N LAKE ST, CRESCENT CITY, FL 32112-2620
(386) 937-0173
Mailing address
116 CONFEDERATE POINT RD, PALATKA, FL 32177-8552
(386) 937-0173
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA11711
FL
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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