Provider Demographics
NPI:1114341674
Name:SLABBERT, AUBREY (HCHI HCHD)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:SLABBERT
Suffix:
Gender:F
Credentials:HCHI HCHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7786 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-3856
Mailing Address - Country:US
Mailing Address - Phone:801-903-3091
Mailing Address - Fax:
Practice Address - Street 1:7786 ROSE ST
Practice Address - Street 2:
Practice Address - City:EAGLE MOUNTAIN
Practice Address - State:UT
Practice Address - Zip Code:84005-3856
Practice Address - Country:US
Practice Address - Phone:801-903-3091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1185174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator