Organization
SELAH THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RE'VIN SLACK LMFT (CLINICAL DIRECTOR)
(909) 522-9690
Entity
Organization
Contact information
Practice address
324 OAK MANOR DR, COLUMBIA, SC 29229-9313
(909) 522-9690
Mailing address
PO BOX 292493, COLUMBIA, SC 29229-0042
(909) 522-9690
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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