PHILLIP ANTHONY BLACK

BROKEN ARROW, OK
NPI1326149873
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: OK  2649)
Enumeration Date2006-09-26
Last Update Date2007-07-08
Business Address
Mr. PHILLIP ANTHONY BLACK M.S.
500 S SWEET GUM AVE
BROKEN ARROW, OK 74012-4543
Phone number: 918-250-5963
Mailing Address
Mr. PHILLIP ANTHONY BLACK M.S.
500 S SWEET GUM AVE
BROKEN ARROW, OK 74012-4543
Phone number: 918-250-5963