CAROLLYN BLACK

MILWAUKEE, WI
NPI1689216293
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  18939-130)
Enumeration Date2019-10-15
Last Update Date2019-10-15
Business Address
CAROLLYN BLACK
4892 N 19TH ST
MILWAUKEE, WI 53209-5757
Phone number: 414-595-3630
Mailing Address
CAROLLYN BLACK
4892 N 19TH ST
MILWAUKEE, WI 53209-5757
Phone number: 414-595-3630
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