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Individual

MICHAEL SLOSNERICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
4110 AVENUE D, SCOTTSBLUFF, NE 69361-4650
(308) 635-3171
Mailing address
200322 ROLLING HILLS RD, SCOTTSBLUFF, NE 69361-5526
(308) 632-3488

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
293
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
470758527-00
NE
Enumeration date
01/10/2007
Last updated
07/08/2007
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