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General NPI Number Information
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NPI Number | 1891997789
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Entity Type | Individual
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Provider Name | FELICIA KELLY SLANEY OT
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Gender | Female
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Dates
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Enumeration Date | 06/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4099 E BRECKENRIDGE WAY
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City | HIGLEY
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State | AZ
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Zip | 85236-3503
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Country | US
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Telephone | 480-202-1227
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 183
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City | ST. LAWRENCE
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State | NL
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Zip | A0E 2V0
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Country | CA
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Telephone | 709-873-2264
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3625
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License Number State | AZ
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