Provider Demographics
NPI:1457558090
Name:SLAYBAUGH, CARMELA JEAN (MA EARLY CHILDHOOD E)
Entity type:Individual
Prefix:MRS
First Name:CARMELA
Middle Name:JEAN
Last Name:SLAYBAUGH
Suffix:
Gender:F
Credentials:MA EARLY CHILDHOOD E
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4045 GUINEVERE DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6417
Mailing Address - Country:US
Mailing Address - Phone:850-478-6117
Mailing Address - Fax:850-469-0858
Practice Address - Street 1:4045 GUINEVERE DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6417
Practice Address - Country:US
Practice Address - Phone:850-478-6117
Practice Address - Fax:850-469-0858
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist