Healthcare Provider Details

I. General information

NPI: 1114992377
Provider Name (Legal Business Name): KAREN DENISE SLATON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 S TYLER ST SUITE B
COVINGTON LA
70433-3036
US

IV. Provider business mailing address

202 S TYLER ST SUITE B
COVINGTON LA
70433-3036
US

V. Phone/Fax

Practice location:
  • Phone: 985-809-1338
  • Fax: 985-809-1331
Mailing address:
  • Phone: 985-809-1338
  • Fax: 985-809-1331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number894
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: