Slack, Tara A

Slack, Tara A is an individual health care provider with primary practice located at 1000 Eddy Street , Providence RI 02905. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Slack, Tara A can be contacted via phone (401) 533-9100.

Contact Information

Primary practice address
1000 Eddy Street Providence RI 02905
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT00837 Rhode Island

Profile Details

NPI number 1831127844
LBN Legal business name Slack, Tara A
Credentials OTR L
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jan 20th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831127844 NPPES
Rhode Island Other 99947 SS BCROSS
Rhode Island Other 409462 SS BCROSS
Rhode Island Other 2058 SS BCROSS
Rhode Island Other 6400144 SS BCROSS

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