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1962710020
AUTUMN FORIE BLACK
PUYALLUP, WA
NPI
1962710020
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2010-09-22
Last Update Date
2010-09-22
Business Address
-- AUTUMN FORIE BLACK
325 E PIONEER AVE
PUYALLUP, WA 98372-3265
Phone number: 253-445-8120
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Mailing Address
-- AUTUMN FORIE BLACK
325 E PIONEER AVE
PUYALLUP, WA 98372-3265
Phone number: 253-445-8120
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