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1326149873
PHILLIP ANTHONY BLACK
BROKEN ARROW, OK
NPI
1326149873
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OK 2649)
Enumeration Date
2006-09-26
Last Update Date
2007-07-08
Business Address
Mr. PHILLIP ANTHONY BLACK M.S.
500 S SWEET GUM AVE
BROKEN ARROW, OK 74012-4543
Phone number: 918-250-5963
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Mailing Address
Mr. PHILLIP ANTHONY BLACK M.S.
500 S SWEET GUM AVE
BROKEN ARROW, OK 74012-4543
Phone number: 918-250-5963
Copy
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