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General NPI Number Information
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NPI Number | 1457596637
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Entity Type | Individual
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Provider Name | RACHEL D SLAGLE LICSW, LCDP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 160 BEECHWOOD AVE
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City | PAWTUCKET
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State | RI
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Zip | 02860-5402
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Country | US
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Telephone | 401-722-5573
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Fax |
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Provider Business Mailing Address
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Address Line | 274 N BROW ST APT 1
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-4435
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Country | US
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Telephone | 207-450-2631
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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 | 338762
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License Number State | ME
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