Provider Demographics
NPI:1932846391
Name:SLATER, SHERI
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:SLATER
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:PO BOX 50207
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84605-0207
Mailing Address - Country:US
Mailing Address - Phone:801-407-4134
Mailing Address - Fax:801-877-0864
Practice Address - Street 1:9494 W FLAMINGO RD STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-5718
Practice Address - Country:US
Practice Address - Phone:702-659-9043
Practice Address - Fax:801-877-0864
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI4075106H00000X
UT13270669-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist