Individual
MICHAEL L. SLAVKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
4646 W JEFFERSON BLVD STE 100, FORT WAYNE, IN 46804-6832
(260) 436-0932
(260) 436-1185
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003541A
IN
Other
Enumeration date
05/22/2017
Last updated
06/10/2019
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