Provider Demographics
NPI:1508145046
Name:SLAY, NANCY LYNN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LYNN
Last Name:SLAY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7006 MODERNA WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-4637
Mailing Address - Country:US
Mailing Address - Phone:407-256-5278
Mailing Address - Fax:
Practice Address - Street 1:7006 MODERNA WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-4637
Practice Address - Country:US
Practice Address - Phone:407-256-5278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11099235Z00000X
TX117347235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist