Provider Demographics
NPI:1700313343
Name:SLAYTON-GARCIA, LAURA ANN (RD, MPH,)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:SLAYTON-GARCIA
Suffix:
Gender:F
Credentials:RD, MPH,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15420 S 37TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6662
Mailing Address - Country:US
Mailing Address - Phone:480-763-6911
Mailing Address - Fax:
Practice Address - Street 1:531 E LYNWOOD ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1626
Practice Address - Country:US
Practice Address - Phone:602-242-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ810060133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered