Provider Demographics
NPI:1699286997
Name:SLATER, CARA (NMD)
Entity type:Individual
Prefix:DR
First Name:CARA
Middle Name:
Last Name:SLATER
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19205 N 39TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-6353
Mailing Address - Country:US
Mailing Address - Phone:928-853-3753
Mailing Address - Fax:
Practice Address - Street 1:2141 E WARNER RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-3493
Practice Address - Country:US
Practice Address - Phone:480-361-5188
Practice Address - Fax:480-304-3208
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ171664175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath