Michael Byron Slack in Travis Afb - Clinical
Michael Byron Slack - NPI 1104939222
Michael Byron Slack is a Clinical in Travis Afb, California. Michael Byron Slack practices all healthcare services and medical treatments related to Clinical. The NPI Number for Michael Byron Slack is 1104939222. The last update date is 2007-07-08.
Michael Byron Slack's current location address is 101 Bodin Cir, Travis Afb, California. You can contact this provider via phone number 7074233811. The mailing address for Michael Byron Slack is 101 Bodin Cir, Travis Afb, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Michael Byron Slack |
|---|---|
| Address | 101 Bodin Cir, Travis Afb, California |
| Phone Number | 7074233811 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D |
NPI Number Detail
| NPI Number | 1104939222 |
|---|---|
| Provider Enumeration Date | 2006-08-15 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 101 Bodin Cir |
|---|---|
| City | Travis Afb |
| State | California (CA) |
| Post Code | 945351809 |
| Phone Number | 7074233811 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LSCSW1952 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique provider identifier assigned to Michael Byron Slack?
The Michael Byron Slack has been issued the NPI (National Provider Identifier) 1104939222 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Michael Byron Slack located?
The Michael Byron Slack is located at 101 Bodin Cir, Travis Afb, CA 945351809.
What is the Michael Byron Slack's area of specialization and corresponding taxonomy classification?
The Michael Byron Slack's specialty field is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their specialties.
On what date was the 1104939222 assigned to Michael Byron Slack?
The Michael Byron Slack was issued its 1104939222 on 2006-08-15, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Michael Byron Slack last refreshed?
The information related to the Michael Byron Slack, including its address, specialty, and other relevant details, was last updated on 2007-07-08.