SHANNON LEE BLACK

VICTORVILLE, CA
NPI1487377784
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2022-09-21
Last Update Date2022-09-21
Business Address
SHANNON LEE BLACK
16248 VICTOR ST
VICTORVILLE, CA 92395-3934
Phone number: 760-243-7151
Mailing Address
SHANNON LEE BLACK
1000 WINDY PASS SPC 154
BARSTOW, CA 92311-5476
Phone number: 442-455-8822