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1215181995
GAIL RENE BLACK
SANTA CRUZ, CA
NPI
1215181995
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Former Name
GAIL RENE WALTERS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA MFC33588)
Enumeration Date
2008-11-08
Last Update Date
2013-10-09
Business Address
MRS. GAIL RENE BLACK MFT
740 FRONT ST STE 350
SANTA CRUZ, CA 95060-4562
Phone number: 831-425-3378
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Mailing Address
MRS. GAIL RENE BLACK MFT
740 FRONT ST STE 350
SANTA CRUZ, CA 95060-4562
Phone number: 831-425-3378
Copy
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