Individual
CYNARA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4006A HAMILTON DR, HILL AIR FORCE BASE, UT 84056
(909) 273-8430
Mailing address
4006A HAMILTON DR, HILL AIR FORCE BASE, UT 84056
(909) 273-8430
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14185146-3503
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/16/2017
Last updated
12/16/2024
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