Provider Demographics
NPI:1801093398
Name:SLAYDEN, MITZIE MICHELLE (MA, CCC-A)
Entity type:Individual
Prefix:
First Name:MITZIE
Middle Name:MICHELLE
Last Name:SLAYDEN
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 HARKREADER RD
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-4040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:590 HARTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2450
Practice Address - Country:US
Practice Address - Phone:615-452-0048
Practice Address - Fax:615-452-0616
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA213231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4097988OtherBCBS
TN4097988OtherBCBS