Provider Demographics
NPI:1215101837
Name:PLATA, DELAYNE SUTTON (MA)
Entity type:Individual
Prefix:
First Name:DELAYNE
Middle Name:SUTTON
Last Name:PLATA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 BIG TYLER RD # D
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1178
Mailing Address - Country:US
Mailing Address - Phone:304-776-6571
Mailing Address - Fax:
Practice Address - Street 1:5400 BIG TYLER RD # D
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-1178
Practice Address - Country:US
Practice Address - Phone:304-776-6571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist