Individual
TRAVIS CAVAZOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1048 ASHLEY ST, SUITE 201, BOWLING GREEN, KY 42103-2449
(270) 904-6567
(270) 904-6570
Mailing address
104 REYNOLDS RD, GLASGOW, KY 42141-1177
(270) 678-4801
(270) 678-3866
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCCCA00218829
KY
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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