Provider Demographics
NPI:1285836577
Name:SLOTE, CAROLYN SUE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:SUE
Last Name:SLOTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 S 24TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-7401
Mailing Address - Country:US
Mailing Address - Phone:479-646-0459
Mailing Address - Fax:
Practice Address - Street 1:1401 S J ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-5158
Practice Address - Country:US
Practice Address - Phone:479-785-3300
Practice Address - Fax:479-785-8516
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR899174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist