Provider Demographics
NPI:1093045585
Name:SLATER, LINDA DENISE (LINDA SLATER)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:DENISE
Last Name:SLATER
Suffix:
Gender:F
Credentials:LINDA SLATER
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:DENISE
Other - Last Name:SLATER-NAGY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LINDA SLATER
Mailing Address - Street 1:11304 ESPERANZA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-4344
Mailing Address - Country:US
Mailing Address - Phone:512-292-0549
Mailing Address - Fax:
Practice Address - Street 1:9206 ROD RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78736-7803
Practice Address - Country:US
Practice Address - Phone:512-809-4280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6577101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor