Provider Demographics
NPI:1528395175
Name:SLOAS, ANTOINETTE KAY
Entity Type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:KAY
Last Name:SLOAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 ANTHONY WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8209
Mailing Address - Country:US
Mailing Address - Phone:859-582-2014
Mailing Address - Fax:859-353-5526
Practice Address - Street 1:209 ANTHONY WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8209
Practice Address - Country:US
Practice Address - Phone:859-582-2014
Practice Address - Fax:859-353-5526
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY200701675174400000X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No174400000XOther Service ProvidersSpecialist