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1972055804
BRANDON SLACKS
MANSFIELD, LA
NPI
1972055804
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: LA 00902654)
Enumeration Date
2016-10-26
Last Update Date
2016-10-26
Business Address
-- BRANDON SLACKS
117 CAROLYN ST
MANSFIELD, LA 71052-2901
Phone number: 318-461-1215
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Mailing Address
-- BRANDON SLACKS
117 CAROLYN ST
MANSFIELD, LA 71052-2901
Phone number:
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