Individual
SHANNON ELAINE SLIZOSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
703 W CANAL ST, PICAYUNE, MS 39466-3918
(601) 590-1580
Mailing address
703 W CANAL ST, PICAYUNE, MS 39466-3918
(601) 590-1580
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0453
MS
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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