Provider Demographics
NPI:1558968826
Name:SLAUGHTER, TABITHA (SOCIAL WORKER)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22
Mailing Address - Street 2:
Mailing Address - City:WAINWRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74468-0022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:928 N YORK ST STE 20
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-3118
Practice Address - Country:US
Practice Address - Phone:918-912-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical