Provider Demographics
NPI:1255903514
Name:SLOAN, KARA MICHELLE
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MICHELLE
Last Name:SLOAN
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 1:12101 PLAYER CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2736
Mailing Address - Country:US
Mailing Address - Phone:804-314-0917
Mailing Address - Fax:
Practice Address - Street 1:3335 S CRATER RD STE 200
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9214
Practice Address - Country:US
Practice Address - Phone:804-765-6660
Practice Address - Fax:804-765-5412
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005478235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist