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General NPI Number Information
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NPI Number | 1821269416
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Entity Type | Individual
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Provider Name | MICHELLE CARDONE SLATER OTR/ L
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Gender | Female
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 19 SOCHA LN
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City | GLENVILLE
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State | NY
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Zip | 12302-3818
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Country | US
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Telephone | 908-472-2697
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Fax |
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Provider Business Mailing Address
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Address Line | 19 SOCHA LN
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City | GLENVILLE
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State | NY
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Zip | 12302-3818
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Country | US
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Telephone | 908-472-2697
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 004061
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 46TR00301800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 196196-1
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License Number State | NY
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