Individual
OLIVIA TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
314 10TH AVE S STE 100, WAITE PARK, MN 56387-1968
(612) 767-7908
Mailing address
314 10TH AVE S STE 100, WAITE PARK, MN 56387-1968
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/17/2023
Last updated
08/23/2024
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