Provider Demographics
NPI:1316059397
Name:SLAVIN, MICHAEL J (AODA COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:SLAVIN
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Gender:M
Credentials:AODA COUNSELOR
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Mailing Address - Street 1:824 JOE ST
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-8432
Mailing Address - Country:US
Mailing Address - Phone:715-345-0711
Mailing Address - Fax:715-345-0223
Practice Address - Street 1:201 PRENTICE ST N
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1162
Practice Address - Country:US
Practice Address - Phone:715-345-0711
Practice Address - Fax:715-345-0223
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI14702OtherCADC III