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Individual
SHEENA SLACK
Active
Individual
SHEENA SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, LMAC, CRAADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
100
KS
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8043
MO
104100000X
Social Worker
10216
KS
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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