Most Relevant Information
Provider Data
| NPI Number: | 1003556424 |
| Provider Name: | ANDREA SLATER |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/01/2022 |
| Last Updated: | 04/01/2022 |
Provider Practice Location
904 M L KING DR
CENTRALIA
IL
628013058
Practice Location Phone/Fax
| Phone: | 6185331391 |
| Fax: |
Provider Mailing Location
904 M L KING DR
CENTRALIA
IL
628013058
Provider Mailing Phone/Fax
| Phone: | 6185331391 |
| Fax: |