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General NPI Number Information
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NPI Number | 1326221623
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Entity Type | Organization
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Legal Business Name | MITZIE MICHELLE SLAYDEN
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Dates
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Enumeration Date | 12/10/2007
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 1313 CENTRAL CT
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City | HERMITAGE
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State | TN
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Zip | 37076-3153
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Country | US
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Telephone | 615-889-4105
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Fax | 615-889-9869
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Provider Business Mailing Address
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Address Line | 1313 CENTRAL CT
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City | HERMITAGE
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State | TN
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Zip | 37076-3153
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Country | US
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Telephone | 615-889-4105
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Fax | 615-889-9869
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Authorized Official
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Title or Position | OWNER
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Name | MS. MITZIE MICHELLE SLAYDEN
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Credential | M.A., CCC-A
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Telephone | 615-889-4105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 213
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License Number State | TN
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