Provider Demographics
NPI:1649376245
Name:SLICKER, ELLEN K (PHD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:K
Last Name:SLICKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 HADDINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2354
Mailing Address - Country:US
Mailing Address - Phone:615-848-0216
Mailing Address - Fax:615-898-5027
Practice Address - Street 1:1810 WARD DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0560
Practice Address - Country:US
Practice Address - Phone:615-895-6942
Practice Address - Fax:615-867-6314
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP-1675103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist