Provider Demographics
NPI:1023813045
Name:SLATTERY, BETH DIMAGGIO
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:DIMAGGIO
Last Name:SLATTERY
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 1:753 ELMEER AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2053
Mailing Address - Country:US
Mailing Address - Phone:504-487-3643
Mailing Address - Fax:
Practice Address - Street 1:2426 ESPLANADE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-2405
Practice Address - Country:US
Practice Address - Phone:504-539-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ10766225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist