Individual
ROBERT WILLIAM BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPPC 17770
Contact information
Practice address
4391 ELM ST, SAN DIEGO, CA 92105-5221
(619) 840-5386
Mailing address
PO BOX 5070, SAN DIEGO, CA 92165-5070
(619) 840-5386
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
17770
CA
Other
Enumeration date
02/28/2019
Last updated
11/06/2024
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