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1992915987
TONI LEIGH BLACK
UKIAH, CA
NPI
1992915987
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA B0502030855)
Enumeration Date
2007-05-22
Last Update Date
2007-07-08
Business Address
TONI LEIGH BLACK
1120 S DORA ST
UKIAH, CA 95482-6340
Phone number: 707-472-2632
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Mailing Address
TONI LEIGH BLACK
1120 S DORA ST
UKIAH, CA 95482-6340
Phone number: 707-472-2632
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