| NPI | 1659572949 |
|---|---|
| Other Name | MANNY WAYNE SLACK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 2943544405) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: UT 2943543102) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2025-09-29 |