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1619529500
JESSICA DAWN BLACK
BOUNTIFUL, UT
NPI
1619529500
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: UT 11070400-6009)
Enumeration Date
2019-07-11
Last Update Date
2019-07-11
Business Address
JESSICA DAWN BLACK ACMHC
1576 S 500 W SUITE 102
BOUNTIFUL, UT 84010
Phone number: 801-406-9002
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Mailing Address
JESSICA DAWN BLACK ACMHC
5398 S 1345 W
RIVERDALE, UT 84405-4000
Phone number: 801-209-1212
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