JOHNATHAN SHANE BLACK

MOBILE, AL
NPI1316459084
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor Mental Health
(Licence: AL  3106)
Enumeration Date2017-11-02
Last Update Date2017-11-02
Business Address
JOHNATHAN SHANE BLACK
7120 AIRPORT BLVD
MOBILE, AL 36608-4502
Phone number: 251-345-3303
Mailing Address
JOHNATHAN SHANE BLACK
7120 AIRPORT BLVD
MOBILE, AL 36608-4502
Phone number: 251-345-3303
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