Provider Demographics
NPI:1932548690
Name:SLATES, DEBRA ANN (CDE)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:SLATES
Suffix:
Gender:F
Credentials:CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MERCHANT ST
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-5213
Mailing Address - Country:US
Mailing Address - Phone:304-366-2710
Mailing Address - Fax:
Practice Address - Street 1:303 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-5213
Practice Address - Country:US
Practice Address - Phone:304-366-2710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator