Individual
CALLIE D SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1540 INTERNATIONAL PKWY, LAKE MARY, FL 32746-5096
(501) 663-1837
Mailing address
1540 INTERNATIONAL PKWY, LAKE MARY, FL 32746-5096
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW16133
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104100000X
—
AR
Enumeration date
10/08/2012
Last updated
03/15/2025
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