Provider Demographics
NPI:1063602316
Name:SLAFKA, MICHAEL ALBERT (COTA/L)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALBERT
Last Name:SLAFKA
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 QUARTZ RDG
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7899
Mailing Address - Country:US
Mailing Address - Phone:412-527-5861
Mailing Address - Fax:
Practice Address - Street 1:1330 INDIA HOOK RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2412
Practice Address - Country:US
Practice Address - Phone:803-326-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2711224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant