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Provider Information for 1538813084


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KYLIE SLAUGHTER LMHC A


Sex: Female

NPI: 1538813084
Last Updated: 2022-02-03
Certification Date: 2022-02-03

Details

NameValue
NPI1538813084
Enumeration Date2022-02-03
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1059 ROSS AVE
DUPONT, WA 98327-9754
United States

Phone: 850-758-5438 | Fax:
 
Primary Practice Address 1059 ROSS AVE
DUPONT, WA 98327-9754
United States

Phone: 850-758-5438 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
CONNECT URL
HTTPS://talkspace.com
Website
Direct Virtual Talkspace Network LLC 1059 Ross Ave
DuPont, WA 98327-9754
United States
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthWAMC61077165