PHYLLIS REGINA BLACK

SEATTLE, WA
NPI1407186869
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CP60097360)
Enumeration Date2010-01-07
Last Update Date2010-01-07
Business Address
-- PHYLLIS REGINA BLACK CDP
325 9TH AVE # 359797
SEATTLE, WA 98104-2420
Phone number: 206-744-9612
Mailing Address
-- PHYLLIS REGINA BLACK CDP
325 9TH AVE # 359797
SEATTLE, WA 98104-2420
Phone number: 206-744-9612
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