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1548713217
JEFF BLACK
SOUTHLAKE, TX
NPI
1548713217
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: TX 69061)
Enumeration Date
2016-07-29
Last Update Date
2016-07-29
Business Address
Mr. JEFF BLACK MA, LPC
578 N KIMBALL AVE SUITE 130
SOUTHLAKE, TX 76092-6883
Phone number: 817-601-5877
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Mailing Address
Mr. JEFF BLACK MA, LPC
578 N KIMBALL AVE SUITE 130
SOUTHLAKE, TX 76092-6883
Phone number: 817-601-5877
Copy
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