Provider Demographics
NPI:1609654177
Name:SLAGUS, KAYLEE MARIE
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:MARIE
Last Name:SLAGUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 S LANCASTER DR APT 301
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-4999
Mailing Address - Country:US
Mailing Address - Phone:605-413-3256
Mailing Address - Fax:
Practice Address - Street 1:315 N MAIN AVE STE 207
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-6024
Practice Address - Country:US
Practice Address - Phone:605-305-3038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker