Individual
MRS. SARAH ELIZABETH SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8601
Mailing address
PO BOX 15, GUTHRIE, KY 42234-0015
(270) 483-2946
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1159
KY
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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