Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 1021 | KY |
Y | 1041C0700X | Clinical Social Worker | 3031 | KY |
NPI | 1003961806 |
---|---|
Provider Name | Mrs. Laura Slaughter |
First Address | Lexington, KY 40504-3377 |
Second Address | Lexington, KY 40504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 25/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30615058 | (05) | KY |