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1811354293
AMY BLACK
MORONI, UT
NPI
1811354293
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-01-15
Last Update Date
2016-01-15
Business Address
-- AMY BLACK
2360 N 1450 E
MORONI, UT 84646-0461
Phone number: 435-445-5520
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Mailing Address
-- AMY BLACK
21360 NORTH 1450 EAST
MORONI, UT 84646-0461
Phone number: 435-445-5200
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