| NPI | 1972716314 |
|---|---|
| Other Name | SKIP BLACK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 300555) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 4476) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-06-21 |