Individual
BEVERLY BOAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16546 N DALE MABRY HWY, TAMPA, FL 33618-1325
(813) 964-8481
Mailing address
13609 LYTTON WAY, TAMPA, FL 33624-2540
(813) 964-8481
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 0002256
FL
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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