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1639941925
MATTHEW JAMES BLACK
SOUTH SALT LAKE, UT
NPI
1639941925
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 11705657-3502)
Enumeration Date
2023-10-30
Last Update Date
2024-05-29
Business Address
MATTHEW JAMES BLACK
331 W 2700 S
SOUTH SALT LAKE, UT 84115-2904
Phone number: 801-678-3317
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Mailing Address
MATTHEW JAMES BLACK
331 W 2700 S
SOUTH SALT LAKE, UT 84115-2904
Phone number: 801-678-3317
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