Individual
MR. SAM EDWARD MCKAY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW/LCSW
Contact information
Practice address
6520 LAUREN DR, SLIDELL, LA 70460-3951
(985) 646-2504
Mailing address
6520 LAUREN DR, SLIDELL, LA 70460-3951
(985) 646-2504
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5819
LA
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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