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1508510744
CECIL J BLACK
MATTOON, IL
NPI
1508510744
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2022-02-07
Last Update Date
2022-02-07
Business Address
CECIL J BLACK BA
750 BROADWAY AVE E
MATTOON, IL 61938-4610
Phone number: 217-238-5735
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Mailing Address
CECIL J BLACK BA
750 BROADWAY AVE E
MATTOON, IL 61938-4610
Phone number: 217-238-5735
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