Individual
JEFFREY DAVID TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLPA
Contact information
Practice address
1575 N MAIN ST, FALL RIVER, MA 02720-2917
(508) 324-1060
Mailing address
1575 N MAIN ST, FALL RIVER, MA 02720-2917
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SP-489-SA
MA
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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