MEDICARE: MS. LAURA LEE SLAUGHTER MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801033011	MI

General Provider Information

NPI Number	:	1548310642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA LEE SLAUGHTER MSW

Provider Business Mailing Address
First Line	:	1844 OAK HOLLOW DR
Second Line	:	SUITE B
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5924
Country	:	US
Telephone Number	:	231-929-0300
Fax Number	:	231-933-6378

Provider Business Practice Location Address
First Line	:	1844 OAK HOLLOW DR
Second Line	:	SUITE B
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5924
Country	:	US
Telephone Number	:	231-929-0300
Fax Number	:	231-933-6378

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	10/11/2012

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