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1871714352
KATHY BLACK
GRASS VALLEY, CA
NPI
1871714352
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA C4001407)
Enumeration Date
2007-05-01
Last Update Date
2007-07-08
Business Address
-- KATHY BLACK CADC I
440 HENDERSON ST STE C
GRASS VALLEY, CA 95945-7374
Phone number: 530-273-9541
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Mailing Address
-- KATHY BLACK CADC I
15019 ROVING WAY
GRASS VALLEY, CA 95949-9708
Phone number: 530-273-9541
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