Provider Demographics
NPI:1639405046
Name:SLAVIN, CORAL C (PHD)
Entity Type:Individual
Prefix:DR
First Name:CORAL
Middle Name:C
Last Name:SLAVIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N77W7063 OAK ST
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-1123
Mailing Address - Country:US
Mailing Address - Phone:262-893-9945
Mailing Address - Fax:
Practice Address - Street 1:N77W7063 OAK ST
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-1123
Practice Address - Country:US
Practice Address - Phone:262-893-9945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula