Individual
CICELY SLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3225 LASALLE ST, CHARLOTTE, NC 28216-4949
(980) 498-2830
Mailing address
9728 FAIRES FARM RD, CHARLOTTE, NC 28213-4211
(404) 268-7754
(704) 910-3628
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251K00000X
Public Health or Welfare Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
347C00000X
Private Vehicle
Primary
874693497
NC
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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