Doctor Name: | JENNIFER BROOKE SLATER |
NPI Number: | 1154547792 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 6523 |
Business Practice Address: | 88 Front St Suite 23b Scituate, MA - 020661314 |
Business Phone Number: | 3395261709 |
Business Fax Number: | |
Mailing Address: | 88 Front St, Suite 23b SCITUATE |
State: | MA |
Postal Code: | 020661314 |
Phone Number: | 3395261709 |
Fax Number: | |
NPI Enumeration Date: | 04/18/2007 |
NPI Last Update Date: | 04/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6523 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |