| NPI | 1437492501 |
|---|---|
| Former Name | LESLIE ELIZABETH BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 10085) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A10085) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2021-10-19 |