Individual
IIESHA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
345 W MEMORIAL DR, HINESVILLE, GA 31313-2413
(912) 456-2010
Mailing address
345 W MEMORIAL DR, HINESVILLE, GA 31313-2413
(912) 456-2010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC015171
GA
Other
Enumeration date
12/03/2024
Last updated
11/06/2025
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