Doctor Name: | SHELLY LEA SLATON |
NPI Number: | 1043510159 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 17355 |
Business Practice Address: | 600 South John Redditt Drive Lufkin, TX - 769043121 |
Business Phone Number: | 9366393233 |
Business Fax Number: | 9366393680 |
Mailing Address: | Po Box 154437, LUFKIN |
State: | TX |
Postal Code: | 759154437 |
Phone Number: | 9366393233 |
Fax Number: | 9366393680 |
NPI Enumeration Date: | 10/25/2010 |
NPI Last Update Date: | 10/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 17355 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |