MEDICARE: TAYLOR ANN SLATTEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	115291	TX

General Provider Information

NPI Number	:	1588129894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR ANN SLATTEN

Provider Business Mailing Address
First Line	:	15480 DALLAS PKWY APT 1097
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-4643
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15480 DALLAS PKWY APT 1097
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-4643
Country	:	US
Telephone Number	:	318-751-7562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2019
Last Update Date	:	01/31/2019

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Directions to “ TAYLOR ANN SLATTEN ” Practice Location

Language	Start Address	Practice Location

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