Individual
CHARLOTTE L BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 SW 27TH ST, RENTON, WA 98057-2603
(206) 630-5160
Mailing address
1200 SW 27TH ST, RENTON, WA 98057-2603
(206) 630-5160
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW60866653
WA
Other
Enumeration date
10/06/2017
Last updated
03/17/2022
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