Provider Demographics
NPI:1689114605
Name:SLONT, ERIN NICOLE (MA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:SLONT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:NICOLE
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:21600 OXNARD ST
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4976
Mailing Address - Country:US
Mailing Address - Phone:818-345-2345
Mailing Address - Fax:818-758-8015
Practice Address - Street 1:1009 44TH ST SW STE 106
Practice Address - Street 2:SUITE 106
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49509-4480
Practice Address - Country:US
Practice Address - Phone:818-345-2345
Practice Address - Fax:818-758-8015
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-16-24502103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst