Individual
KASHALA SMITH-TAVARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
60 KATONA DR STE 24, FAIRFIELD, CT 06824-3544
(203) 576-0142
(866) 608-3856
Mailing address
60 KATONA DR STE 24, FAIRFIELD, CT 06824-3544
(203) 567-0142
(866) 608-3856
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
003820
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003820
CT LICENSE IN SPEECH LANGUAGE PATHOLOGY
CT
Enumeration date
02/02/2020
Last updated
08/27/2020
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