Individual
MRS. SAMANTHA DENISE SLAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
26 MIDWAY ST, BRISTOL, TN 37620-1706
(423) 989-4500
(423) 989-4582
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
5290
TN
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
5290
TN
Other
Enumeration date
03/30/2007
Last updated
04/28/2021
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