Individual
CRISTABELLE TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1135 MINERAL SPRING AVE, NORTH PROVIDENCE, RI 02904-4102
(401) 351-0610
Mailing address
95 CEDAR ST, PROVIDENCE, RI 02903-1062
(401) 751-6333
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
Primary
SP00502-P
RI
Other
Enumeration date
02/01/2018
Last updated
05/07/2022
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