Doctor Name: | MS. STEPHANIE JUNE SLOAN |
NPI Number: | 1063661759 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, MHCNS |
License Number: | 005618 |
Business Practice Address: | 365 Montauk Ave New London, CT - 063204700 |
Business Phone Number: | 8604420711 |
Business Fax Number: | |
Mailing Address: | 365 Montauk Ave, NEW LONDON |
State: | CT |
Postal Code: | 063204700 |
Phone Number: | 8604420711 |
Fax Number: | |
NPI Enumeration Date: | 09/17/2008 |
NPI Last Update Date: | 12/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 005618 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |