Individual
MRS. MARTHA ANN SLATTERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
875 WALNUT ST, SUITE 220, CARY, NC 27511-4215
(919) 467-1180
(919) 467-1712
Mailing address
8604 TIMBERWIND DR, RALEIGH, NC 27615-2615
(919) 325-9868
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1082
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1082
MFT LICENSE
NC
01
—
11652936
CAQH
NC
Enumeration date
03/06/2007
Last updated
07/08/2007
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