Healthcare Provider Details

I. General information

NPI: 1306326186
Provider Name (Legal Business Name): ALLISON SLAUGHTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 W CHARLESTON BLVD STE 140
LAS VEGAS NV
89146-1067
US

IV. Provider business mailing address

6901 E LAKE MEAD BLVD APT 2086
LAS VEGAS NV
89156-1158
US

V. Phone/Fax

Practice location:
  • Phone: 702-437-4673
  • Fax: 702-438-4673
Mailing address:
  • Phone: 702-439-6329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number8037-S
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: