Provider Demographics
NPI:1710190996
Name:SLIMMER, LARA M (MA)
Entity Type:Individual
Prefix:MS
First Name:LARA
Middle Name:M
Last Name:SLIMMER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19526-1114
Mailing Address - Country:US
Mailing Address - Phone:610-914-4502
Mailing Address - Fax:
Practice Address - Street 1:3940 LOCUST LN
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4023
Practice Address - Country:US
Practice Address - Phone:717-545-5787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health