Provider Demographics
NPI:1477095586
Name:SLOBODA, NATALIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:
Last Name:SLOBODA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 BETHANY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-8106
Mailing Address - Country:US
Mailing Address - Phone:828-245-2852
Mailing Address - Fax:
Practice Address - Street 1:830 BETHANY CHURCH RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-8106
Practice Address - Country:US
Practice Address - Phone:828-245-2852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11203235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist