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General NPI Number Information
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NPI Number | 1679947832
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Entity Type | Individual
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Provider Name | REBECKAH KITTEN SLATKO LCAT, ATR-BC
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Gender | Female
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Dates
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Enumeration Date | 11/25/2015
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Last Update Date | 07/26/2019
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Provider Practice Location Address
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Address Line | 10601 CIVIC CENTER DR STE A-D
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730
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Country | US
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Telephone | 917-734-5671
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Fax |
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Provider Business Mailing Address
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Address Line | 10601 CIVIC CENTER DR STE A-D
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3878
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Country | US
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Telephone | 917-734-5671
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 001905
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License Number State | NY
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