Provider Demographics
NPI:1922478536
Name:SLATER, DARRIENNE (NMD)
Entity Type:Individual
Prefix:DR
First Name:DARRIENNE
Middle Name:
Last Name:SLATER
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 S MITCHELL DR
Mailing Address - Street 2:#C
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3545
Mailing Address - Country:US
Mailing Address - Phone:432-288-5841
Mailing Address - Fax:
Practice Address - Street 1:8300 N HAYDEN RD
Practice Address - Street 2:A111
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-2458
Practice Address - Country:US
Practice Address - Phone:480-922-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15-1499175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath