Provider Demographics
NPI:1821316241
Name:SLATER, RACHEL (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:SLATER
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 RAYMOND AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1701
Mailing Address - Country:US
Mailing Address - Phone:612-405-7057
Mailing Address - Fax:651-797-4523
Practice Address - Street 1:970 RAYMOND AVE STE 105
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1701
Practice Address - Country:US
Practice Address - Phone:612-405-7057
Practice Address - Fax:651-797-4523
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-10
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5141103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling