Individual
ALISON SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3620 W WHITE RIVER BLVD, MUNCIE, IN 47304-4286
(765) 288-1928
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33008910A
IN
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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