Individual
SANDRA CATHERINE TAVISORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCTM
Contact information
Practice address
6961 PUETOLLANO DR, N LAS VEGAS, NV 89084-2339
(480) 650-2010
Mailing address
6961 PUETOLLANO DR, N LAS VEGAS, NV 89084-2339
(480) 650-2010
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NVMT3113
NV
Other
Enumeration date
11/28/2007
Last updated
12/19/2007
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