Individual
TANYA LANE SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13971 N CLEVELAND AVE STE 9, NORTH FORT MYERS, FL 33903-4392
(239) 997-7770
(239) 997-7776
Mailing address
13971 N CLEVELAND AVE STE 9, NORTH FORT MYERS, FL 33903-4392
(239) 997-7770
(239) 997-7776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
121425
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
190
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
50516
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADC011451-2015
FL
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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