Individual
TEQUILA LASHAUN SLOCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9238 MADISON BLVD, MADISON, AL 35758-9100
(256) 774-8342
Mailing address
4443 MILLVALE DR SW, HUNTSVILLE, AL 35805-5617
(404) 751-7809
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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