Provider Demographics
NPI:1366599276
Name:SLATER, JOYCE K (PHD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:K
Last Name:SLATER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 MONUMENT AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3613
Mailing Address - Country:US
Mailing Address - Phone:804-353-2266
Mailing Address - Fax:804-285-0111
Practice Address - Street 1:4908 MONUMENT AVE STE 203
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3613
Practice Address - Country:US
Practice Address - Phone:804-353-2266
Practice Address - Fax:804-285-0111
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002904103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical