Healthcare Provider Details

I. General information

NPI: 1790604007
Provider Name (Legal Business Name): SUZANNE SLADE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2890 HARLAN ST APT 202
WHEAT RIDGE CO
80214-8165
US

IV. Provider business mailing address

2890 HARLAN ST APT 202
WHEAT RIDGE CO
80214-8165
US

V. Phone/Fax

Practice location:
  • Phone: 267-467-6512
  • Fax:
Mailing address:
  • Phone: 267-467-6512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: