Provider Demographics
NPI:1235460742
Name:SLAUGHTER, HOLLEN AYERS
Entity Type:Individual
Prefix:
First Name:HOLLEN
Middle Name:AYERS
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOLLEN
Other - Middle Name:
Other - Last Name:AYERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:201 CAPE COD DR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32407-2873
Mailing Address - Country:US
Mailing Address - Phone:850-208-4100
Mailing Address - Fax:
Practice Address - Street 1:201 CAPE COD DR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-2873
Practice Address - Country:US
Practice Address - Phone:850-208-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT 14050OtherLICENSE