Provider Demographics
NPI:1669903597
Name:SONYA SLATER PSYD PSYCHOLOGIST LLC
Entity type:Organization
Organization Name:SONYA SLATER PSYD PSYCHOLOGIST LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:614-310-4940
Mailing Address - Street 1:6209 RIVERSIDE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-6028
Mailing Address - Country:US
Mailing Address - Phone:614-310-4940
Mailing Address - Fax:614-310-4941
Practice Address - Street 1:6209 RIVERSIDE DR STE 200
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-6028
Practice Address - Country:US
Practice Address - Phone:614-310-4940
Practice Address - Fax:614-310-4941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty