Provider Demographics
NPI:1033899760
Name:SLAYTON, KATHARINE VICTORIA (MED)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:VICTORIA
Last Name:SLAYTON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 TOWER OFFICE PARK STE 401
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-2120
Mailing Address - Country:US
Mailing Address - Phone:781-935-1310
Mailing Address - Fax:
Practice Address - Street 1:10 TOWER OFFICE PARK STE 401
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-2120
Practice Address - Country:US
Practice Address - Phone:781-935-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health