Healthcare Provider Details

I. General information

NPI: 1740100809
Provider Name (Legal Business Name): TAYLOR M SLAUGHTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 STATE HIGHWAY NN
CHARLESTON MO
63834-8245
US

IV. Provider business mailing address

1055 STATE HIGHWAY NN
CHARLESTON MO
63834-8245
US

V. Phone/Fax

Practice location:
  • Phone: 573-233-4923
  • Fax:
Mailing address:
  • Phone: 573-233-4923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number2024032829
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: