| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SHANESE LAE'TRELLE SLY | 1750908976 | 2020-07-03 |
Shanese Lae'trelle Sly is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1750908976. Registration indicates Shanese Lae'trelle Sly is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Professional, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Professional, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Shanese Lae'trelle Sly LPC |
| Practice Office Address | 3335 CARTWRIGHT RD STE 250 MISSOURI CITY, TX US |
| Practice Office Telephone | 2816107968 |
| Mailing Address | 1510 MONTERRA PT FRESNO, TX 775452028 US |
| Business Telephone | 2816107968 |
| Code | Practice | License No State |
|---|---|---|
| 101YP2500X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Professional Behavioral Health/Substance Abuse/Psychiatry Counselor Professional Behavioral Health & Social Service Providers Counselor | 80107
TX |