Provider Demographics
NPI:1649302282
Name:SLATER, LOU ANN (MA)
Entity type:Individual
Prefix:
First Name:LOU
Middle Name:ANN
Last Name:SLATER
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 1:383 WARD HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-5937
Mailing Address - Country:US
Mailing Address - Phone:931-695-3193
Mailing Address - Fax:
Practice Address - Street 1:383 WARD HOLLOW RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-5937
Practice Address - Country:US
Practice Address - Phone:931-695-3193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health