Doctor Name: | SANDRA CATHERINE TAVISORA |
NPI Number: | 1376725648 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NCTM |
License Number: | NVMT3113 |
Business Practice Address: | 6961 Puetollano Dr N Las Vegas, NV - 890842339 |
Business Phone Number: | 4806502010 |
Business Fax Number: | |
Mailing Address: | 6961 Puetollano Dr, N LAS VEGAS |
State: | NV |
Postal Code: | 890842339 |
Phone Number: | 4806502010 |
Fax Number: | |
NPI Enumeration Date: | 11/28/2007 |
NPI Last Update Date: | 12/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | NVMT3113 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |