Individual
MRS. JUSTINE SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 3RD AVE, FAIRBANKS, AK 99701-4455
(907) 452-4222
Mailing address
PO BOX 71248, FAIRBANKS, AK 99707-1248
(907) 452-4222
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020977
—
AK
Enumeration date
04/17/2019
Last updated
01/22/2020
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