Individual
MRS. TARA D. SLATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
413 BLAKE RD, NITRO, WV 25143-1919
(304) 755-2418
Mailing address
413 BLAKE RD, NITRO, WV 25143-1919
(304) 755-2418
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-0854
WV
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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