Provider Demographics
NPI:1225589575
Name:SLAYDON, ANNA MICHELLE
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MICHELLE
Last Name:SLAYDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MICHELLE
Other - Last Name:BARDOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:122 GAZEBO DR
Mailing Address - Street 2:
Mailing Address - City:ELON
Mailing Address - State:NC
Mailing Address - Zip Code:27244-7678
Mailing Address - Country:US
Mailing Address - Phone:336-317-4007
Mailing Address - Fax:
Practice Address - Street 1:122 GAZEBO DR
Practice Address - Street 2:
Practice Address - City:ELON
Practice Address - State:NC
Practice Address - Zip Code:27244-7678
Practice Address - Country:US
Practice Address - Phone:336-317-4007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional