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Individual

MRS. GAYLE LINDSAY SLATEN HERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., MFT

Contact information

Practice address
209 W HERRON BOULEVARD KP N, LAKEBAY, WA 98349-8186
(916) 783-7254
(253) 884-1248
Mailing address
209 W HERRON BOULEVARD KP N, LAKEBAY, WA 98349-8186
(916) 783-7254
(253) 884-1248

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF00002663
WA
106H00000X
Marriage & Family Therapist
MFC24750
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001067987
MHN
CA
01
1021-02
PACIFICARE
CA
01
A137329
VALUE OPTIONS
CA
01
ZZZ56345Z
BLUE SHIELD
CA
Enumeration date
07/26/2006
Last updated
05/13/2011
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