Individual
MS. MARY KATHLEEN ROBINSON-BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
1003 HAUCK DR, ROLLA, MO 65401-2584
(573) 368-7302
(573) 368-7300
Mailing address
1003 HAUCK DR, ROLLA, MO 65401-2584
(573) 368-7302
(573) 368-7300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2001007821
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2001007821
MO
101YM0800X
Mental Health Counselor
2001007821
MO
101YP2500X
Professional Counselor
2001007821
MO
Other
Enumeration date
03/05/2010
Last updated
03/05/2010
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