Individual
JACOB WILLIAM SLATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
230 WORCESTER ST, WELLESLEY, MA 02481-5420
(781) 431-5400
Mailing address
230 WORCESTER ST, WELLESLEY, MA 02481-5420
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10000302
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/07/2021
Last updated
04/12/2024
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