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1407186869
PHYLLIS REGINA BLACK
SEATTLE, WA
NPI
1407186869
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CP60097360)
Enumeration Date
2010-01-07
Last Update Date
2010-01-07
Business Address
-- PHYLLIS REGINA BLACK CDP
325 9TH AVE # 359797
SEATTLE, WA 98104-2420
Phone number: 206-744-9612
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Mailing Address
-- PHYLLIS REGINA BLACK CDP
325 9TH AVE # 359797
SEATTLE, WA 98104-2420
Phone number: 206-744-9612
Copy
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