| Doctor Name: | SUELLYN VANDERSLICE |
| NPI Number: | 1003971722 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | PY 4182 |
| Business Practice Address: | 1202 Christel Ave Panama City, FL - 324012030 |
| Business Phone Number: | 8507855325 |
| Business Fax Number: | 9042120170 |
| Mailing Address: | 1202 Christel Ave, PANAMA CITY |
| State: | FL |
| Postal Code: | 324012030 |
| Phone Number: | 8507855325 |
| Fax Number: | 9042120170 |
| NPI Enumeration Date: | 12/22/2006 |
| NPI Last Update Date: | 09/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY 4182 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |