Provider Information for 1700156007
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Ms. ERIN L BLACK LCSW
Sex: Female
NPI: 1700156007
Last Updated: 2016-02-24
Certification Date:
Certification Date:
Details
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NPI | 1700156007 | ||||||||
Enumeration Date | 2012-01-04 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 426 14TH ST STE 119 MODESTO, CA 95354-2661 United States Phone: 209-222-8515 | Fax: | ||||||||
Primary Practice Address | 426 14TH ST STE 119 MODESTO, CA 95354-2661 United States Phone: 209-222-8515 | Fax: | ||||||||
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