Provider Demographics
NPI:1891997789
Name:SLANEY, FELICIA KELLY (OT)
Entity Type:Individual
Prefix:MISS
First Name:FELICIA
Middle Name:KELLY
Last Name:SLANEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 183
Mailing Address - Street 2:
Mailing Address - City:ST. LAWRENCE
Mailing Address - State:NL
Mailing Address - Zip Code:A0E 2V0
Mailing Address - Country:CA
Mailing Address - Phone:709-873-2264
Mailing Address - Fax:
Practice Address - Street 1:4099 E BRECKENRIDGE WAY
Practice Address - Street 2:
Practice Address - City:HIGLEY
Practice Address - State:AZ
Practice Address - Zip Code:85236-3503
Practice Address - Country:US
Practice Address - Phone:480-202-1227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3625225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist