NPI 1376725648

Sandra Catherine Tavisora, NCTM

Practitioner Specialist N Las Vegas, NV

Practice location

Address: 6961 Puetollano Dr, N Las Vegas, NV 89084-2339
Phone: (480) 650-2010

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence NVMT3113 (NV)

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Registry record

NPI: 1376725648
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Nov 2007
Record last updated: 19 Dec 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.