BRUCE BLACK

SANTA ROSA, CA
NPI1285185819
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy167G00000X Licensed Psychiatric Technician
(Licence: CA  PT 31504)
Enumeration Date2016-10-19
Last Update Date2016-10-19
Business Address
Mr. BRUCE BLACK Psych Tech
2225 CHALLENGER WAY
SANTA ROSA, CA 95407
Phone number: 707-576-8181
Mailing Address
Mr. BRUCE BLACK Psych Tech
2225 CHALLENGER WAY
SANTA ROSA, CA 95407-5441
Phone number: 707-576-8181