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1174724546
TEQUILA LASHAUN SLOCUM
MADISON, AL
NPI
1174724546
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Former Name
TEQUILA1 LASHAUN UPSHAW
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2007-05-31
Last Update Date
2007-07-08
Business Address
-- TEQUILA LASHAUN SLOCUM
9238 MADISON BLVD
MADISON, AL 35758-9100
Phone number: 256-774-8342
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Mailing Address
-- TEQUILA LASHAUN SLOCUM
4443 MILLVALE DR SW
HUNTSVILLE, AL 35805-5617
Phone number: 404-751-7809
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