Individual
MS. MAGAN SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4282 MEMORIAL DR STE C, DECATUR, GA 30032-1218
(770) 778-4061
Mailing address
4282 MEMORIAL DR STE C, DECATUR, GA 30032-1218
(770) 778-4061
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC005063
GA
Other
Enumeration date
03/16/2011
Last updated
03/16/2011
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