Provider Demographics
NPI:1831862028
Name:SLAUGHTER, YOKA
Entity type:Individual
Prefix:
First Name:YOKA
Middle Name:
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4173 N 72ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1035
Mailing Address - Country:US
Mailing Address - Phone:414-514-2497
Mailing Address - Fax:
Practice Address - Street 1:524 MONUMENT SQ STE 206
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-1013
Practice Address - Country:US
Practice Address - Phone:414-514-2497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator