Provider Demographics
NPI:1679086094
Name:SLADE, REBECCAH (SW)
Entity Type:Individual
Prefix:
First Name:REBECCAH
Middle Name:
Last Name:SLADE
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 N MCKEAN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4928
Mailing Address - Country:US
Mailing Address - Phone:724-282-0332
Mailing Address - Fax:724-282-2406
Practice Address - Street 1:349 N MCKEAN ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4928
Practice Address - Country:US
Practice Address - Phone:724-282-0332
Practice Address - Fax:724-282-2406
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker