Individual
MRS. TERRI TARRANT SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC, LPC
Contact information
Practice address
1741 W 33RD ST, SUITE 100, EDMOND, OK 73013-3837
(405) 401-1464
Mailing address
1741 W 33RD ST STE 100, EDMOND, OK 73013-3838
(405) 401-1464
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
638
OK
101YP2500X
Professional Counselor
4164
OK
Other
Enumeration date
01/01/2009
Last updated
10/16/2014
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