Individual
DR. NICOLE JOY SLAVIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D. , LP
Contact information
Practice address
6425 NICOLLET AVE, RICHFIELD, MN 55423-1675
(612) 798-8170
Mailing address
6425 NICOLLET AVE, RICHFIELD, MN 55423-1675
(612) 798-8170
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 5609
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750552196
BCBS
MN
05
—
87055600
—
MN
01
—
C01290
MEDICARE PTAN
MN
Enumeration date
04/25/2013
Last updated
04/25/2013
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