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General NPI Number Information
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NPI Number | 1780857615
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Entity Type | Individual
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Provider Name | MR. WILLIAM ALLEN SLUYTER
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Gender | Male
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 04/11/2008
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Provider Practice Location Address
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Address Line | 3115 N GARDEN AVE
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City | ROSWELL
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State | NM
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Zip | 88201-7760
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Country | US
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Telephone | 575-627-0147
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Fax | 575-622-8506
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Provider Business Mailing Address
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Address Line | 3115 N GARDEN AVE
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City | ROSWELL
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State | NM
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Zip | 88201-7760
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Country | US
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Telephone | 575-627-0147
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Fax | 575-622-8506
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0111911
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License Number State | NM
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