Provider Demographics
NPI:1073740510
Name:SLAYTON, SHONITRA ALVITA (BSW)
Entity Type:Individual
Prefix:
First Name:SHONITRA
Middle Name:ALVITA
Last Name:SLAYTON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 CEDAR FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND
Mailing Address - State:VA
Mailing Address - Zip Code:24569-3207
Mailing Address - Country:US
Mailing Address - Phone:703-483-5698
Mailing Address - Fax:
Practice Address - Street 1:793 CEDAR FOREST RD
Practice Address - Street 2:
Practice Address - City:LONG ISLAND
Practice Address - State:VA
Practice Address - Zip Code:24569-3207
Practice Address - Country:US
Practice Address - Phone:703-483-5698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator