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1003107731
LEAH BLACK
JACKSON, WY
NPI
1003107731
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Other Name
LEAH HURST
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WY LCSW-742)
Enumeration Date
2011-04-28
Last Update Date
2015-02-18
Business Address
-- LEAH BLACK LCSW
310 E BROADWAY AVE
JACKSON, WY 83001-8636
Phone number: 307-654-7003
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Mailing Address
-- LEAH BLACK LCSW
PO BOX 13572
JACKSON, WY 83002-3572
Phone number: 307-654-7003
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