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1003175183
SUSAN EASTON BLACK
PROVO, UT
NPI
1003175183
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: UT 8133414-2504)
Enumeration Date
2012-05-10
Last Update Date
2012-05-10
Business Address
-- SUSAN EASTON BLACK
1190 N 900 E
PROVO, UT 84604-3536
Phone number: 801-422-7620
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Mailing Address
-- SUSAN EASTON BLACK
1190 N 900 E
PROVO, UT 84604-3536
Phone number: 801-422-7620
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