Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kristine Leigh Tavrisov, MSCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1467029009

Kristine Leigh Tavrisov, MSCCC-SLP is a Speech-Language Pathologist in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2021.

Licensed in
FL
In the registry since
2021

Practice location Address checks out

11420 Campfield Cir
Jacksonville, FL 32256-3907
Phone: (904) 910-1065
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SA20512 (FL)

Record details

NPI number1467029009
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCC-SLP
Sole proprietorNo
NPI enumeratedJune 10, 2021
Last updated in NPPESOctober 18, 2023
Certification dateOctober 18, 2023

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