| NPI | 1780820357 |
|---|---|
| Former Name | TERRI LYNN SLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 638) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 4164) |
| Enumeration Date | 2009-01-01 |
| Last Update Date | 2014-10-16 |