Basic Information
| Provider Information | |||||||||
| NPI: | 1245612530 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANKIN | ||||||||
| FirstName: | SLOAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1113 MURFREESBORO RD STE 319 | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370641312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157900567 | ||||||||
| FaxNumber: | 6158142924 | ||||||||
| Practice Location | |||||||||
| Address1: | 1113 MURFREESBORO RD STE 202 | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157900567 | ||||||||
| FaxNumber: | 6158142924 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2015 | ||||||||
| LastUpdateDate: | 02/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YS0200X | 2951 | TN | N | Behavioral Health & Social Service Providers | Counselor | School | 101YP2500X | 2951 | TN | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.