Healthcare Provider Details

I. General information

NPI: 1427973023
Provider Name (Legal Business Name): HALLIE K SLOCUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 HAGGARD CT
LEXINGTON KY
40505-1534
US

IV. Provider business mailing address

1950 HAGGARD COURT
FAYETTE KY
40405
US

V. Phone/Fax

Practice location:
  • Phone: 859-447-2309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-431506
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: