Healthcare Provider Details

I. General information

NPI: 1255256541
Provider Name (Legal Business Name): SLOAN KYLER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 SPINK ST
WOOSTER OH
44691-3652
US

IV. Provider business mailing address

104 SPINK ST
WOOSTER OH
44691-3652
US

V. Phone/Fax

Practice location:
  • Phone: 330-264-8498
  • Fax: 330-264-3777
Mailing address:
  • Phone: 330-264-8498
  • Fax: 330-264-3777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2614020
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: