Healthcare Provider Details

I. General information

NPI: 1558889865
Provider Name (Legal Business Name): LINDA MARIE SLONE MA REV
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 NAVAHO CT
NEWARK DE
19702-1910
US

IV. Provider business mailing address

112 NAVAHO CT
NEWARK DE
19702-1910
US

V. Phone/Fax

Practice location:
  • Phone: 302-836-4834
  • Fax: 302-793-9423
Mailing address:
  • Phone: 302-836-4834
  • Fax: 302-793-9423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: