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General NPI Number Information
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NPI Number | 1124347505
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Entity Type | Individual
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Provider Name | BETH ANNE SLAUGHTER LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 06/25/2021
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Provider Practice Location Address
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Address Line | MADIGAN ARMY MEDICAL CTR 9040 REID ST., ATTN:MCHJ-QCR
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City | TACOMA
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State | WA
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Zip | 98431-1100
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Country | US
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Telephone | 253-968-2252
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Fax |
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Provider Business Mailing Address
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Address Line | 565 E BROWN AVE
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City | FRESNO
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State | CA
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Zip | 93704-5406
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Country | US
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Telephone | 559-355-1336
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 26173
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License Number State | CA
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