Individual
MANDY NICHOLE SLADKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
1217 1ST ST NW, ALBUQUERQUE, NM 87102-1529
(505) 766-5197
Mailing address
PO BOX 25445, ALBUQUERQUE, NM 87125-0445
(505) 766-5197
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
163W00000X
Registered Nurse
Primary
63266
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123190
—
OR
Enumeration date
07/29/2011
Last updated
09/26/2022
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