| NPI | 1164678918 |
|---|---|
| Professional Name | JACK SLOCOMB |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD 04526) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 04256) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2008-08-12 |