| NPI | 1215435466 |
|---|---|
| Professional Name | AVEEAVISA TERRRYSEENA BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LCDCIII.021224) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 111922) |
| 1041C0700X Social Worker Clinical (Licence: OH W.0000977) | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |