Provider Demographics
NPI:1295407781
Name:SLAYTON, JAMIE C (PEER SPECIALIST)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:C
Last Name:SLAYTON
Suffix:
Gender:F
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3632 CUSHING DR APT D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-3232
Mailing Address - Country:US
Mailing Address - Phone:614-927-8390
Mailing Address - Fax:
Practice Address - Street 1:3632 CUSHING DR APT D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-3232
Practice Address - Country:US
Practice Address - Phone:614-927-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-02
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0002654175T00000X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty