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Individual
MRS. FRANCES TAYLOR SLACK RAESIDE
Active
Individual
MRS. FRANCES TAYLOR SLACK RAESIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MFC35637
CA
101YM0800X
Mental Health Counselor
MFC35637
NULL
101YP2500X
Professional Counselor
MFC35637
CA
106H00000X
Marriage & Family Therapist
Primary
MFC35637
CA
Other
Enumeration date
10/27/2007
Last updated
10/27/2007
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