Doctor Name: | TREACHA SLATTMAN |
NPI Number: | 1134558018 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.C., C.R.C |
License Number: | 101Y00000X |
Business Practice Address: | 12557 Ravenwood Dr Chardon, OH - 440249009 |
Business Phone Number: | 4402853568 |
Business Fax Number: | |
Mailing Address: | 228 Orchard St, Down FAIRPORT HARBOR |
State: | OH |
Postal Code: | 44077 |
Phone Number: | 4193099775 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2013 |
NPI Last Update Date: | 11/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 101Y00000X |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |