Individual
TABITHA ANN BURNARD-TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1823 BUSINESS PARK BLVD, DAYTONA BEACH, FL 32114-1230
(386) 254-1931
Mailing address
1823 BUSINESS PARK BLVD, DAYTONA BEACH, FL 32114-1230
(386) 254-1931
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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