ALYSSA NICOLE BLACK

PROVO, UT
NPI1821635095
Former NameALYSSA NICOLE COSTANZA
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2019-12-05
Last Update Date2019-12-05
Business Address
Mrs. ALYSSA NICOLE BLACK
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
Mailing Address
Mrs. ALYSSA NICOLE BLACK
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760