Provider Demographics
NPI:1871073247
Name:TAVERAS, KARINA (SLPA)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:TAVERAS
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 UPPER BALCONES RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-8546
Mailing Address - Country:US
Mailing Address - Phone:210-360-1662
Mailing Address - Fax:
Practice Address - Street 1:20702 STONE OAK PKWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7478
Practice Address - Country:US
Practice Address - Phone:210-544-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst