Provider Demographics
NPI:1447986716
Name:SLAY, REGINA L
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:L
Last Name:SLAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-2529
Mailing Address - Country:US
Mailing Address - Phone:419-376-7972
Mailing Address - Fax:
Practice Address - Street 1:411 SUNSET BLVD LOWR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-2529
Practice Address - Country:US
Practice Address - Phone:419-376-7972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes374U00000XNursing Service Related ProvidersHome Health Aide